Blickensderfer, Janelle Ruth

Blickensderfer, Janelle Ruth is an individual health care provider with primary practice located at 515 N Lafayette Blvd , South Bend IN 46601-1003. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Blickensderfer, Janelle Ruth can be contacted via phone (574) 232-2037.

Contact Information

Primary practice address
515 N Lafayette Blvd South Bend IN 46601-1003
Phone: (574) 232-2037
Fax: (574) 232-1420
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 02001307A Indiana

Profile Details

NPI number 1477505543
LBN Legal business name Blickensderfer, Janelle Ruth
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date May 17th, 2006
Last updated Feb 10th, 2010 - about 15 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 1477505543 NPPES
Indiana MEDICAID 100339290A

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