Provider Demographics
NPI:1467188003
Name:BLISSENBACH, CARRIE ANNE (WHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:ANNE
Last Name:BLISSENBACH
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14517 SEIGLER RD
Mailing Address - Street 2:
Mailing Address - City:LISBON
Mailing Address - State:OH
Mailing Address - Zip Code:44432-9700
Mailing Address - Country:US
Mailing Address - Phone:330-420-5049
Mailing Address - Fax:
Practice Address - Street 1:14517 SEIGLER RD
Practice Address - Street 2:
Practice Address - City:LISBON
Practice Address - State:OH
Practice Address - Zip Code:44432-9700
Practice Address - Country:US
Practice Address - Phone:330-420-5049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-26
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0031963363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health