Provider Demographics
NPI:1275610925
Name:BLAIR, ALENE R (FNP)
Entity Type:Individual
Prefix:
First Name:ALENE
Middle Name:R
Last Name:BLAIR
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 N CENTER ST
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-3759
Mailing Address - Country:US
Mailing Address - Phone:828-855-3644
Mailing Address - Fax:828-855-3351
Practice Address - Street 1:1205 N CENTER ST
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-3759
Practice Address - Country:US
Practice Address - Phone:828-855-3644
Practice Address - Fax:828-855-3351
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200529363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7000108Medicaid
NC2596468Medicare ID - Type Unspecified
NC7000108Medicaid