NPI 1396945663 · live from the CMS NPI Registry
Cory W Blocker, PNP
Nurse Practitioner, Pediatrics in Dexter, MO. National Provider Identifier 1396945663, active.
NPI record
| NPI | 1396945663 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Pediatrics 363LP0200X |
| Practice location | 1200 N One Mile Rd, Dexter, MO 63841 |
| Practice phone | 573-624-7575 |
| Mailing address | 3100 Oak Grove Rd, Poplar Bluff, MO 63901 |
| Enumerated | July 24, 2007 |
| Last updated | October 7, 2015 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Pediatrics primary | 363LP0200X | 148700 (MO) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.