Individual
MR. JUSTIN C BLINN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGACNP-BC
Contact information
Practice address
520 MARY ST STE 520, EVANSVILLE, IN 47710-1682
(812) 424-8231
(812) 435-8794
Mailing address
520 MARY ST STE 520, EVANSVILLE, IN 47710-1682
(812) 424-8231
(812) 435-8794
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
71011444A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001580588
BCBS
—
05
—
300054833
—
IN
05
—
7100768810
—
KY
01
—
71011444
INDIANA STATE LICENSE
IN
Enumeration date
07/14/2021
Last updated
03/05/2024
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