Blagg, Kelli Lynn

Blagg, Kelli Lynn is an individual health care provider with primary practice located at 10555 East County Road 800 N , Mattoon IL 61938-3574. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Blagg, Kelli Lynn can be contacted via phone (217) 235-4227.

Contact Information

Primary practice address
10555 East County Road 800 N Mattoon IL 61938-3574
Phone: (217) 235-4227
Fax: (217) 235-4274
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 209005102 Illinois

Profile Details

NPI number 1679676738
LBN Legal business name Blagg, Kelli Lynn
Credentials FNP APN
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 6th, 2006
Last updated Sep 18th, 2015 - about 9 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 1679676738 NPPES
Illinois Other P00322001 RAILROAD MEDICARE

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