Individual provider · NPI-1

Rebecca Jean Blatt

General Practice · Thornton, CO

NPI number1255530838
StatusActive
Last updated in NPPESMay 10, 2024

Details

NPI
1255530838
Entity type
Individual (NPI-1)
Name
Rebecca Jean Blatt
Sex
Female
Sole proprietor
No
Enumeration date
Jul 13, 2007
Certification date
May 10, 2024
Last updated
May 10, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208D00000X General PracticeDR.0049804COYes
207P00000X Emergency Medicine48616CT
207P00000X Emergency MedicineMD2018-0017NM
207P00000X Emergency MedicineDR.0049804CO
2083X0100X Preventive Medicine, Occupational MedicineDR.0049804CO

Other names

  • Rebecca J. Blatt (Professional Name)

Practice location

9191 Grant St.
Thornton, CO 80229-8812

Phone 303-450-4482 · Fax 303-306-7753

Mailing address

Po Box 26666
Phs Provider Enrollment
Albuquerque, NM 87125-6666

Phone 505-923-5362 · Fax 505-923-5362

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