Individual
JESSICA LOUISE BLAZKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
87 MCGREGOR ST STE 3100, MANCHESTER, NH 03102-3766
(603) 627-1887
(603) 536-1544
Mailing address
PO BOX 706, PLYMOUTH, NH 03264-0706
(603) 481-8757
(603) 238-2163
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0996
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3095759
—
NH
Enumeration date
02/08/2014
Last updated
04/09/2021
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