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Contact Information

ANDREA BLACKHAM
750 N FREEDOM BLVD
PROVO, UT84601-1677
 Phone: 801-373-4760
 Fax: 801-373-0639
 Website:
Indicates primary specialty

NPI Profile & details for ANDREA BLACKHAM · (Female)

NPI Number 1093161390
Status Active
Credentials
Entity Individual
Enumeration date 05/05/2016
Last updated 02/21/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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