Blackledge, Patricia Louise

Blackledge, Patricia Louise is an individual health care provider with primary practice located at 1015 N 18Th St , Centerville IA 52544-1170. She recently has 3 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Blackledge, Patricia Louise can be contacted via phone (641) 684-6896.

Contact Information

Primary practice address
1015 N 18Th St Centerville IA 52544-1170
Phone: (641) 684-6896
Fax: (641) 226-5759
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 097156 Iowa
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X A097156 Iowa
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X A097156 Iowa

Profile Details

NPI number 1871586271
LBN Legal business name Blackledge, Patricia Louise
Credentials ARNP MS
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2005
Last updated Dec 29th, 2023 - about last year

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 1871586271 NPPES
Iowa MEDICAID 3254342
Iowa Other 36504
Iowa Other 420681060C4

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