Blackburn, Monica

Blackburn, Monica is an individual health care provider with primary practice located at 1 Medical Village Dr Independent Anesthesiologists Psc, Edgewood KY 41017-3403. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Blackburn, Monica can be contacted via phone (859) 341-7246.

Contact Information

Primary practice address
1 Medical Village Dr Independent Anesthesiologists Psc Edgewood KY 41017-3403
Phone: (859) 341-7246
Fax: (859) 341-7867
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 1047367 Kentucky

Profile Details

NPI number 1679558167
LBN Legal business name Blackburn, Monica
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 7th, 2005
Last updated Aug 28th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679558167 NPPES
Other 000000288565 BLUE SHIELD
MEDICAID 200416410 BLUE SHIELD
MEDICAID 74476144 BLUE SHIELD
MEDICAID 2380963 BLUE SHIELD

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