Provider Demographics
NPI:1427315886
Name:BLAIR, LAURA LYLA (RN)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:LYLA
Last Name:BLAIR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:886 YORKHAVEN RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45240-1226
Mailing Address - Country:US
Mailing Address - Phone:513-262-1325
Mailing Address - Fax:
Practice Address - Street 1:886 YORKHAVEN RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45240-1226
Practice Address - Country:US
Practice Address - Phone:513-262-1325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-23
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH343739163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse