Provider Demographics
NPI:1336661917
Name:BLAIR, HELEN ELIZABETH (BSN, RN)
Entity Type:Individual
Prefix:MRS
First Name:HELEN
Middle Name:ELIZABETH
Last Name:BLAIR
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16414 HAMPDEN PL
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63034-3395
Mailing Address - Country:US
Mailing Address - Phone:314-413-6939
Mailing Address - Fax:
Practice Address - Street 1:16414 HAMPDEN PL
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63034-3395
Practice Address - Country:US
Practice Address - Phone:314-413-6939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-14
Last Update Date:2022-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010024041163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOK200003021OtherSTATE ID