CONSTANCE FAYE BLAISDELL


Address: 2350 N Rockton Ave, Rockford, IL 61103-3600
Phone: 8159712200

CONSTANCE FAYE BLAISDELL (NPI# 1588135529) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1588135529
Entity Type Individual
Full Name CONSTANCE FAYE BLAISDELL
Credential NP
Practice Address 2350 N Rockton Ave
Rockford
IL 61103-3600
Mailing Address 8158 Royal Oaks Rd
Rockford
IL 61107-2845
Practice Telephone 8159712200
Practice Fax Number 8159719097
Mailing Telephone 8159798723
Enumeration Date 2018-12-17
Last Update Date 2020-08-28
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
209018537 IL Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
WI 1588135529 05

Office Location

Street Address 2350 N ROCKTON AVE
City ROCKFORD
State IL
Zip Code 61103-3600

Providers in the same location

NPI Name Taxonomy Address Enumeration
1801899935 Dean T Fochios Orthopaedic Surgery 2350 N Rockton Ave, Rockford, IL 61103-3600 2005-05-23
1518593342 Leah Burns Physician Assistant 2350 N Rockton Ave, Rockford, IL 61103-3600 2020-03-12
1275185142 Brenda Ann Beilfuss Nurse Practitioner 2350 N Rockton Ave, Rockford, IL 61103-3600 2019-07-11
1982144762 Lu Ann Ostrander Nurse Practitioner 2350 N Rockton Ave, Rockford, IL 61103-3600 2017-02-28
1821476359 Hanna J Rakowski Nurse Practitioner 2350 N Rockton Ave, Suite 304, Rockford, IL 61103-3600 2015-05-17
1770854085 Meghan Hess Nurse Practitioner 2350 N Rockton Ave, Rockford, IL 61103-3600 2012-01-18
1578792511 Maxine Mathew Internal Medicine 2350 N Rockton Ave, Internal Medicine Dept, Rockford, IL 61103-3600 2009-07-13
1194965129 Kevin Harold Ruggles Psychiatry & Neurology 2350 N Rockton Ave, Rockford, IL 61103-3600 2009-03-04
1477726396 Spiros K. Analitis, M.d.,p.c. General Acute Care Hospital 2350 N Rockton Ave, Rockford, IL 61103-3600 2008-04-11
1235312331 Tajinderpal Saraon Internal Medicine 2350 N Rockton Ave, Rockford, IL 61103-3619 2007-12-11
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1598398497 The Elitist Group Home Health Aide 2929 N Main Street, Rockford, IL 61103 2020-02-19
1972064194 Mahita Bellamkonda Student in an Organized Health Care Education/Training Program 2400 North Rockton Avenue, Rockford, IL 61103 2019-03-29
1558538967 Willows Health Center Clinic/Center 4143 Albright Lane, Rockford, IL 61103 2008-05-14
1497845135 Humaira Bari Internal Medicine 2400 N. Rockton Avenue, Rockford, IL 61103 2006-10-13
1841385242 Rachel Pawlowski Occupational Therapist 3616 N. Main Street, Rockford, IL 61103 2006-10-03
1417068438 Alicia Anne Huntley Midwife 2400 Rockton Ave, Rockford, IL 61103 2006-08-31
1639190200 Glendon Burress Pediatrics 2300 N. Rockton Ave., Rockford Health Physicians, Rockford, IL 61103 2006-07-21
1225065204 Daniel William Johnson Dentist 519 Toner Av, Rockford, IL 61103 2006-06-27
1760472898 Ronald Peter Oberfoell Anesthesiology 2400 North Rockton Ave, Rockford Health Physicians, Rockford, IL 61103 2005-10-28
1841752532 Dipti Sabharwal Student in an Organized Health Care Education/Training Program 2400 N Rockton Avenue, Rockford, IL 61103 2019-04-02
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1174138481 Kelly Ann Twigg Nurse Practitioner 5669 Shelley Rd, Rockford, OH 45882-9577 2020-09-14
1699389882 Mary Ann Shaw Nurse Practitioner 207 W Main Ave, Rockford, IA 50468-1213 2020-09-04
1124632922 Catherine Nwosu Nurse Practitioner 3455 Holiday Dr Apt 10, Rockford, IL 61109-2489 2020-08-31
1790314631 Toni A Hughart Nurse Practitioner 6000 E State St, Rockford, IL 61108-2521 2020-04-03
1578199220 Keli S Griseta Nurse Practitioner 3505 N Bell School Rd, Rockford, IL 61114-6624 2020-03-13
1457986069 Nicole P Falatic Nurse Practitioner 153 Glen Eagle Dr Ne, Rockford, MI 49341-1183 2020-03-04
1194367912 Matt J Kriebs Nurse Practitioner 1235 N Mulford Rd Suite 103, Rockford, IL 61107 2019-10-14
1952869943 Angela Marie Hawkins Nurse Practitioner 8201 E. Riverside Blvd, Pediatric Neurology, Rockford, IL 61114 2019-03-08
1487110540 Karrie Hagger Nurse Practitioner 7476 Countryshire Ln, Rockford, IL 61107-2774 2019-02-13
1336652700 Stacey Jo Caler Nurse Practitioner 363 Financial Ct Unit 300, Rockford, IL 61107-6671 2017-11-08
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Competitor

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City ROCKFORD
Zip Code 61103

Improve Information

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Dataset Information

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.

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