Blaisdell, Shawn

Blaisdell, Shawn is an individual health care provider with primary practice located at 1001 Medical Arts Ave Ne , Albuquerque NM 87102-2708. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Midwife, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Blaisdell, Shawn can be contacted via phone (505) 272-0457.

Contact Information

Primary practice address
1001 Medical Arts Ave Ne Albuquerque NM 87102-2708
Fax: (505) 272-2043
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Midwife 176B00000X 425 New Mexico
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R37437 New Mexico

Profile Details

NPI number 1083649065
LBN Legal business name Blaisdell, Shawn
Credentials CFNP, CNM
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 11th, 2006
Last updated May 23rd, 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 1083649065 NPPES
New Mexico MEDICAID 17605717

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