Individual
MS. CORI L BLASA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
10012 KENNERLY RD, #301 GATEWAY CARDIOLOGY PC, ST LOUIS, MO 63128
(314) 729-0088
(314) 729-3974
Mailing address
11140 S TOWNE SQUARE, SUITE #105, ST LOUIS, MO 63123
(314) 894-0787
(314) 729-3963
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
149338
MO
163W00000X
Registered Nurse
41307283
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
149338
RN LIC
MO
01
—
41307283
RN LIC
IL
Enumeration date
05/31/2007
Last updated
07/08/2007
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