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Individual

ABIGAIL LAINE BLANC

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
600 BLUES LAKE PKWY, ROLLA, MO 65401-8022
(573) 458-8822
Mailing address
1877 OSAGE DR, ROLLA, MO 65401-8167
(573) 263-4773

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2023012588
MO

Other

Enumeration date
04/05/2023
Last updated
04/05/2023
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