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Individual

REBECCA M BLADES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1722 SHAFFER ST, KALAMAZOO, MI 49048-1633
(269) 343-1555
Mailing address
5943 STADIUM DR, STE 1, KALAMAZOO, MI 49009-3016

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704132533
MI
364SA2200X
Adult Health Clinical Nurse Specialist
2012012206
MI

Other

Enumeration date
10/03/2012
Last updated
10/03/2012
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