Individual
MRS. FANCHON G. BLACKSHIRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3620 N RANCHO DR STE 103, LAS VEGAS, NV 89130-3153
(702) 321-4825
Mailing address
3620 N RANCHO DR STE 103, LAS VEGAS, NV 89130-3153
(702) 321-4825
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/24/2013
Last updated
06/24/2013
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