Individual
REBECCA JEAN BLATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9191 GRANT ST., THORNTON, CO 80229-8812
(303) 450-4482
(303) 306-7753
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-5362
(505) 923-5362
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
48616
CT
207P00000X
Emergency Medicine Physician
DR.0049804
CO
207P00000X
Emergency Medicine Physician
MD2018-0017
NM
2083X0100X
Occupational Medicine Physician
DR.0049804
CO
208D00000X
General Practice Physician
Primary
DR.0049804
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
81654278
—
CO
Enumeration date
07/13/2007
Last updated
05/10/2024
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