Individual
MRS. KATHLEEN TEAMAN BLAZOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, BC
Contact information
Practice address
7733 E JEFFERSON AVE, DETROIT, MI 48214-3707
(313) 499-4923
(313) 499-4089
Mailing address
218 MCKINLEY AVE, GROSSE POINTE FARMS, MI 48236-3507
(313) 499-4923
(313) 499-4089
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4704162765
MI
Other
Enumeration date
09/28/2006
Last updated
07/08/2007
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