Provider Demographics
NPI:1659512952
Name:BLASH, JANE LUCILLE (CRNP)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:LUCILLE
Last Name:BLASH
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CENTER DR
Mailing Address - Street 2:CLINICAL RESEARCH CENTER 3-2341
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20892-0001
Mailing Address - Country:US
Mailing Address - Phone:301-451-0493
Mailing Address - Fax:301-480-3160
Practice Address - Street 1:10 CENTER DR
Practice Address - Street 2:CLINICAL RESEARCH CENTER 3-2341
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20892-0001
Practice Address - Country:US
Practice Address - Phone:301-451-0493
Practice Address - Fax:301-480-3160
Is Sole Proprietor?:No
Enumeration Date:2009-03-16
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR071666363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care