Blackshear, Mia Lynnae

Blackshear, Mia Lynnae is an individual health care provider with primary practice located at 1827 Holburn Ave , Columbus OH 43207-1681. She recently has 2 registered licenses in different health care specialties including Nursing Service Related Providers / Nurse's Aide, Nursing Service Providers / Licensed Practical Nurse. Nursing Service Providers / Licensed Practical Nurse is her primary health care specialty. Blackshear, Mia Lynnae can be contacted via phone (614) 599-9687.

Contact Information

Primary practice address
1827 Holburn Ave Columbus OH 43207-1681
Phone: (614) 599-9687
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Related Providers / Nurse's Aide 376K00000X 401195000111 Ohio
Nursing Service Providers / Licensed Practical Nurse 164W00000X 152393 Ohio

Profile Details

NPI number 1902184328
LBN Legal business name Blackshear, Mia Lynnae
Credentials Licensed Practical Nurse (LPN)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 2nd, 2011
Last updated Apr 15th, 2015 - about 11 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 1902184328 NPPES
Ohio MEDICAID 0061631

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