Individual
JENNIFER BLAYLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
A172505
IA
363LP2300X
Primary Care Nurse Practitioner
Primary
A172505
IA
Other
Enumeration date
01/11/2023
Last updated
03/25/2024
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