| Provider / Organization | NPI | Date Certified |
|---|---|---|
| MALLORY E BLAIR | 1114664869 | 2022-05-15 |
Mallory E Blair is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1114664869. Registration indicates Mallory E Blair is a provider of access to mental health/behavioral health providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Nurse Practitioner: Psych/Mental Health, ) (All Other Specialties & Provider Types, ) (Nurse Practitioner Psych/Mental Health, Physician Assistants & Advanced Practice Nursing Providers) (Nurse Practitioner, )
| Entity Type | Individual |
| Provider Name | Mallory E Blair PMHNP-BC |
| Practice Office Address | 3 HOSPITAL DR COLUMBIA, MO US |
| Practice Office Telephone | 5738828913 |
| Practice Office Fax | 5738841070 |
| Mailing Address | PO BOX 843966 KANSAS CITY, MO 641843966 US |
| Business Telephone | 5738843300 |
| Business Fax | 5738840943 |
| Endpoint is used to receive electronic continuity of care documents (C-CDA) for outpatient referrals. [Direct] | [email protected] | Direct Curators of the University of Missouri |
| Code | Practice | License No State |
|---|---|---|
| 363LP0808X PRIMARY | Access to Mental Health/Behavioral Health Providers Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Nurse Practitioner: Psych/Mental Health All Other Specialties & Provider Types Nurse Practitioner Psych/Mental Health Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | 2022015302
MO |
| 420110976 | MEDICAID | MO |