Individual
JAMIE BLAGBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3706 FORT AVE, WACO, TX 76710-5335
(903) 818-4872
Mailing address
3706 FORT AVE, WACO, TX 76710-5335
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
728901
TX
Other
Enumeration date
02/19/2018
Last updated
02/19/2018
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