Individual
MS. TARA LESLIE BLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, APRN, CCNS
Contact information
Practice address
227 FALCON DR STE 101, MT STERLING, KY 40353-9792
(859) 497-5135
(859) 497-5140
Mailing address
PO BOX 936, LONDON, KY 40743-0936
(606) 330-7818
(606) 330-7825
Taxonomy
Speciality
Code
Description
License number
State
364SA2100X
Acute Care Clinical Nurse Specialist
Primary
3007961
KY
364SC0200X
Critical Care Medicine Clinical Nurse Specialist
3007961
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100257800
—
KY
Enumeration date
05/08/2013
Last updated
05/06/2019
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