Individual
JILL JUNE BLACHARSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
224 MONTCLAIRE DR NE, ALBUQUERQUE, NM 87108-1124
(505) 264-5770
Mailing address
224 MONTCLAIRE DR NE, ALBUQUERQUE, NM 87108-1124
(505) 264-5770
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
86-175
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10009939
LOVELACE HEALTH/SALUD
NM
01
—
201000856
PRESBYTERIAN HEALTH/SALUD
NM
05
—
826589
—
AZ
01
—
85031326887301A154
CHAMPUS
NM
05
—
9605
—
NM
01
—
NM0023965
BCBS
NM
Enumeration date
02/01/2006
Last updated
05/01/2023
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