Individual
MEGHAN BLAYLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
4021 AVENUE B, SCOTTSBLUFF, NE 69361-4602
(308) 630-3711
(308) 630-3711
Mailing address
1406 AVENUE J, SCOTTSBLUFF, NE 69361-4148
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
112260
NE
363LA2200X
Adult Health Nurse Practitioner
112260
NE
363LG0600X
Gerontology Nurse Practitioner
112260
NE
Other
Enumeration date
07/03/2017
Last updated
07/03/2017
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