Individual
INDIA M. BLUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
327 1ST AVE NW, HICKORY, NC 28601-6122
(828) 695-5900
Mailing address
327 1ST AVE NW, HICKORY, NC 28601-6122
(828) 695-5900
(828) 695-4256
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
104209
NC
363AM0700X
Medical Physician Assistant
104209
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578860110
—
NC
Enumeration date
02/17/2011
Last updated
09/14/2016
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