Individual
MRS. INGRID L BLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2051 W GRAND BLVD, DETROIT, MI 48208-1105
(313) 961-3200
Mailing address
25850 BEECH CT, SOUTHFIELD, MI 48033-2824
(810) 874-3112
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704262720
MI
363L00000X
Nurse Practitioner
Primary
4704262720
MI
Other
Enumeration date
07/09/2012
Last updated
12/20/2018
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