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Individual

LYNN BLAKESLEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
4235 SECOR RD, TOLEDO, OH 43623-4231
(419) 479-5690
Mailing address
4235 SECOR RD, TOLEDO, OH 43623-4231

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN215578 NP01206
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2173698
OH
Enumeration date
07/05/2005
Last updated
05/25/2011
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