Provider Demographics
NPI:1467344853
Name:BLAIR, BONNIE S
Entity type:Individual
Prefix:
First Name:BONNIE
Middle Name:S
Last Name:BLAIR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 6TH AVE W
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-0028
Mailing Address - Country:US
Mailing Address - Phone:304-525-8014
Mailing Address - Fax:304-525-8026
Practice Address - Street 1:10 6TH AVE W
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-0028
Practice Address - Country:US
Practice Address - Phone:304-525-8014
Practice Address - Fax:304-525-8026
Is Sole Proprietor?:No
Enumeration Date:2025-07-18
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant