Provider Demographics
NPI:1891841375
Name:BLIMLING, RONALD H (FNP/PA)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:H
Last Name:BLIMLING
Suffix:
Gender:M
Credentials:FNP/PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5344 W. CYPRESS AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277
Mailing Address - Country:US
Mailing Address - Phone:559-625-6080
Mailing Address - Fax:
Practice Address - Street 1:5344 W. CYPRESS AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277
Practice Address - Country:US
Practice Address - Phone:559-625-6080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3976363L00000X
CAPA#12407363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant