CONSTANCE FAYE BLAISDELL NP NPI 1588135529

NPI Information

NPI: 1588135529
Provider Name: CONSTANCE FAYE BLAISDELL, NP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Organization: ROCKFORD HEALTH PHYSICIANS

PECOS Registration: Yes

Address:
2350 N ROCKTON AVE
ROCKFORD, IL
ZIP 61103
Phone: (815) 971-2200
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Constance Faye Blaisdell, NP is a family nurse practitioner in Rockford, IL with 6 years of experience. Constance Faye Blaisdell, NP NPI is 1588135529. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2350 N ROCKTON AVE
ROCKFORD, IL
ZIP 61103-600
Phone: (815) 971-2200
Fax: (815) 971-9097

The NPI 1588135529 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 12/17/2018 and was last updated on 8/28/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	209018537	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1588135529	MEDICAID	WISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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