Candice J Blackert is a Family in Peoria, Illinois. Candice J Blackert practices all healthcare services and medical treatments related to Family. The NPI Number for Candice J Blackert is 1710108899. The last update date is 2007-07-08.
Candice J Blackert's current location address is 530 Ne Glen Oak Ave, Peoria, Illinois. You can contact this provider via phone number 3096552000 and fax number 3096557869. The mailing address for Candice J Blackert is 530 Ne Glen Oak Ave, Peoria, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Candice J Blackert |
|---|---|
| Address | 530 Ne Glen Oak Ave, Peoria, Illinois |
| Phone Number | 3096552000 |
| Fax Number | 3096557869 |
| Sole Proprietor | N |
| Credentials | F.N.P. |
NPI Number Detail
| NPI Number | 1710108899 |
|---|---|
| Provider Enumeration Date | 2007-05-02 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 530 Ne Glen Oak Ave |
|---|---|
| City | Peoria |
| State | Illinois (IL) |
| Post Code | 616370001 |
| Phone Number | 3096552000 |
| Fax Number | 3096557869 |
Provider's Primary Taxonomy Detail
| Speciality | Family |
|---|---|
| Taxonomy | 363Lf0000X |
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Definition: An advanced practice registered nurse expert in primary healthcare for patients of all ages. |
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Post Comment/ Review Below
What is the Candice J Blackert's 1710108899?
The Candice J Blackert's NPI (National Provider Identifier) Number is 1710108899. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical address where Candice J Blackert is geographically located?
The Candice J Blackert is physically situated at the following location: 530 Ne Glen Oak Ave, Peoria, IL, 616370001.
What is the Candice J Blackert's area of specialization and corresponding taxonomy classification?
The Candice J Blackert's specialty field is Family, and it falls under the taxonomy code 363Lf0000X, which categorizes healthcare providers based on their specialties.
On what date did the Candice J Blackert receive the assignment of its 1710108899 from the Centers for Medicare & Medicaid Services?
The Candice J Blackert was issued its 1710108899 by the Centers for Medicare & Medicaid Services on 2007-05-02.
As of what date was the information regarding Candice J Blackert, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Candice J Blackert, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2007-07-08.
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