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NPI Profile for CORY W BLOCKER in DEXTER, MO.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Pediatrics |
363LP0200X | 50 | Nurse Practitioner |
| NPI Number | 1396945663 |
|
| Status | Active | |
| Credentials | PNP | |
| Entity | Individual | |
| Enumeration date | 07/24/2007 | |
| Last updated | 10/07/2015 - About 11 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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CORY W BLOCKER
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CORY W BLOCKER, PNP