Karen Dyer Blackwell, P.A. Valid NPI

Individual provider · Physician Assistant · O Fallon, IL

NPI

1487983664

Type

Individual (Type 1)

Primary specialty

Physician Assistant

Specialty group

Physician Assistants & Advanced Practice Nursing Providers

Taxonomy code

363A00000X

License number

085005182 (IL)

Sex

Female

Sole proprietor

No

Enumerated

2009-12-16

Last updated

2016-02-22