Blickensderfer, Kelly J

Blickensderfer, Kelly J is an individual health care provider with primary practice located at 1215 Ridgewood Dr Suite B, Bowling Green OH 43402-2690. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Blickensderfer, Kelly J can be contacted via phone (419) 352-9071.

Contact Information

Primary practice address
1215 Ridgewood Dr Suite B Bowling Green OH 43402-2690
Fax: (419) 352-9073
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X COA.09007-NP Ohio

Profile Details

NPI number 1528145026
LBN Legal business name Blickensderfer, Kelly J
Credentials Certified Family Nurse Practitioner (CFNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 1st, 2006
Last updated Jun 15th, 2022 - about 2 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1528145026 NPPES
Ohio MEDICAID 2954147

Popular Providers