Individual
JESSICA MARIE BLANDFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
701 SUPERIOR AVE STE 2500, MUNSTER, IN 46321-4037
(219) 934-9852
(219) 836-7593
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01093562A
IN
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/19/2019
Last updated
03/23/2026
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