Individual
AMY BLACKLEDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3250 W CHERRY LN, MERIDIAN, ID 83642-1120
(208) 302-6404
Mailing address
326 W SCREECH OWL DR, KUNA, ID 83634-3528
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
Primary
41313
ID
Other
Enumeration date
06/05/2020
Last updated
06/05/2020
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