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Individual

ANDREW JOSEPH BLAES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
3105 MCCLELLAND BLVD., JOPLIN, MO 64804-1640
(417) 347-5400
Mailing address
PO BOX 3810, JOPLIN, MO 64803-3810
(417) 347-4662

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2015005447
MO
363LA2100X
Acute Care Nurse Practitioner
2015005447
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
53-77168-032
KANSAS NURSING LICENSE
KS
Enumeration date
02/24/2015
Last updated
10/19/2022
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