SUSAN LYNNE BLAKEMORE (NPI# 1437583390) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1437583390 |
Entity Type | Individual |
Full Name | SUSAN LYNNE BLAKEMORE |
Credential | RN,BSN,MSN,ANP, FNP |
Practice Address |
3750 Landmark Dr Lafayette IN 47905-6652 |
Practice Telephone | 7654484511 |
Mailing Telephone | 7654484511 |
Enumeration Date | 2013-08-28 |
Last Update Date | 2019-04-15 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
A0213010 | IN | Physician Assistants & Advanced Practice Nursing Providers |
N | 363LF0000X |
Nurse Practitioner Specialization: Family |
F1214194 | IN | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
3750 LANDMARK DR |
City | LAFAYETTE |
State | IN |
Zip Code | 47905-6652 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1073531257 | Samuel Horton | Psychiatry & Neurology | 3750 Landmark Dr, Suite A, Lafayette, IN 47905-6633 | 2006-07-17 |
1407231442 | Rachel Erin Pennington | Specialist/Technologist, Other | 3750 Landmark Dr, Suite B, Lafayette, IN 47905-6652 | 2015-07-20 |
1336381631 | Garrett J Jackson | Neurological Surgery | 3750 Landmark Dr, Suite B, Lafayette, IN 47905-6652 | 2009-04-01 |
1417169244 | Patricia Ann Beaty | Physical Therapist | 3750 Landmark Dr, Suite A, Lafayette, IN 47905-6652 | 2007-05-04 |
1932286481 | Thomas Bridge | Family Medicine | 3750 Landmark Dr, Suite A, Lafayette, IN 47905-6633 | 2006-11-01 |
1639256191 | Wasima Hassan | Family Medicine | 3750 Landmark Dr, Suite A, Lafayette, IN 47905-6633 | 2006-11-01 |
1487731964 | Thomas Petry | Family Medicine | 3750 Landmark Dr, Suite A, Lafayette, IN 47905-6633 | 2006-11-01 |
1457438830 | James Watson | Family Medicine | 3750 Landmark Dr, Suite A, Lafayette, IN 47905-6633 | 2006-11-01 |
1386721777 | Ramona Bass | Nurse Practitioner | 3750 Landmark Dr, Suite A, Lafayette, IN 47905-6633 | 2006-11-01 |
1477630853 | Karla Ross | Nurse Practitioner | 3750 Landmark Dr, Suite A, Lafayette, IN 47905-6633 | 2006-11-01 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1538719893 | Elements Counseling LLC | Social Worker | 115 N. Farabee Drive, Lafayette, IN 47905 | 2019-09-18 |
1134596869 | Indiana Dental Sleep Therapy LLC | Dentist | 4921 Sr 26 E, Suite 300, Lafayette, IN 47905 | 2015-08-28 |
1255750899 | Emily S Miller | Physical Therapist | 1701 Creasy Ln, Lafayette, IN 47905 | 2014-04-10 |
1073876215 | Nathan Webster | Dentist | 1530 Kossuth St., Lafayette, IN 47905 | 2012-06-22 |
1578848370 | Mark Jin Kim | Pharmacist | 1801 South St., Lafayette, IN 47905 | 2011-10-13 |
1700177185 | Shannon Tawn Harris | Speech-Language Pathologist | 8900 Cobbler Lane, Lafayette, IN 47905 | 2011-04-20 |
1508164484 | David Thomas Beine | Specialist/Technologist | 1321 Unity Pl Ste A, Lafayette, IN 47905 | 2011-03-02 |
1447569538 | Deidre Dudley | Nurse Practitioner | 1701 S Creasy Ln Ste 1w93, Lafayette, IN 47905 | 2010-10-07 |
1548493067 | Unity Healthcare, LLC | Podiatrist | 750 Park East Blvd, Unit 4, Lafayette, IN 47905 | 2009-09-01 |
1073762969 | Lynette Marie Alexander | Nurse Practitioner | 5500 St Rd. 38 East, Lafayette, IN 47905 | 2008-09-16 |
Find all providers in zip 47905 |
Taxonomy Code | 363LA2200X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Adult Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1285182550 | Elizabeth Anne Summerhayes | Nurse Practitioner | 3542 Oconner Dr, Lafayette, CA 94549-4933 | 2016-09-15 |
1194106674 | Jessica J. Meredith | Nurse Practitioner | 4118 Trees Dr, Lafayette, IN 47909-3450 | 2015-06-10 |
1013291350 | Shelly Sebastien Richard | Nurse Practitioner | 501 W Saint Mary Blvd Ste 200, Lafayette, LA 70506-4665 | 2011-10-05 |
1134442692 | Christine Devillier Richard | Nurse Practitioner | 522 Harrell Dr, Lafayette, LA 70503-4935 | 2010-03-11 |
1679761761 | Grace Ihsiu Todd | Nurse Practitioner | 964 Mezzanine Dr, Planned Parenthood of Indiana and Kentucky, Lafayette, IN 47905-8631 | 2007-10-15 |
1396761060 | Deirdre Irene Detraz | Nurse Practitioner | 2801 Kaliste Saloom Rd, Suite 200 B, Lafayette, LA 70508-7181 | 2006-07-14 |
1861451106 | Anne Elizabeth Zahnke | Nurse Practitioner | 1 W 240 S, Lafayette, IN 47909-6303 | 2006-03-23 |
1194728568 | Gilbert Almanza | Nurse Practitioner | 1345 Unity Pl, Suite 345, Lafayette, IN 47905-5760 | 2005-05-31 |
1891330726 | Sarah Roth | Nurse Practitioner | 3750 Landmark Dr Ste B, Lafayette, IN 47905-6652 | 2019-11-14 |
1235774431 | Rdd Consulting | Nurse Practitioner | 3400 Moss St Ste B, Lafayette, LA 70507-6114 | 2019-11-12 |
Find all providers in LAFAYETTE |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.