Provider Demographics
NPI:1215731609
Name:BLASSE, JASLYN
Entity type:Individual
Prefix:
First Name:JASLYN
Middle Name:
Last Name:BLASSE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3304 CHERRY HILL DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:12603-1772
Mailing Address - Country:US
Mailing Address - Phone:318-730-4468
Mailing Address - Fax:
Practice Address - Street 1:3304 CHERRY HILL DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:NY
Practice Address - Zip Code:12603-1772
Practice Address - Country:US
Practice Address - Phone:318-730-4468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY521172163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse