Individual
ELIZABETH DIANE BLAGG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3737 LANDER RD, PEPPER PIKE, OH 44124-5712
(216) 831-2255
Mailing address
3737 LANDER RD, PEPPER PIKE, OH 44124-5712
(216) 831-2255
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN184747
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2871101
—
OH
Enumeration date
05/15/2017
Last updated
07/21/2022
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