Individual
JESSICA DANIELLE BLUST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
907 KENRIDGE DR, VILLA HILLS, KY 41017
(513) 237-8283
Mailing address
907 KENRIDGE ST, VILLA HILLS, KY 41017-1155
(513) 237-8283
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
2046175
KY
164W00000X
Licensed Practical Nurse
Primary
PN.138705-M-IV
OH
Other
Enumeration date
08/31/2013
Last updated
03/31/2016
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