Blackshear, Brenda Lee

Blackshear, Brenda Lee is an individual health care provider with primary practice located at 5300 Harroun Rd , Sylvania OH 43560-2182. 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. Blackshear, Brenda Lee can be contacted via phone (419) 824-1100.

Contact Information

Primary practice address
5300 Harroun Rd Sylvania OH 43560-2182
Phone: (419) 824-1100
Fax: (419) 824-1778
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 396 Ohio

Profile Details

NPI number 1699773499
LBN Legal business name Blackshear, Brenda Lee
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2005
Last updated Jan 5th, 2010 - about 16 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 1699773499 NPPES
Ohio MEDICAID 2017838

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