Individual provider Active NPI

Amy Leigh Blickhahn, RN, BSN

  • School Registered Nurse
  • Lake Elsinore, CA
National Provider Identifier
1730748757
Registry record updated Jun 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
476931 Issued in CA
Practice address
28755 El Toro Rd
Lake Elsinore, CA 92532-1912
Phone
(951) 249-4693
NPI assigned
Jun 12, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 476931 CA Primary

Addresses

Primary practice location

28755 El Toro Rd
Lake Elsinore, CA 92532-1912

Mailing address

28755 El Toro Rd
Lake Elsinore, CA 92532-1912
Phone (951) 249-4693

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
476931CAMDSchool Registered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1730748757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28755 EL TORO RD",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925321912",
            "telephone_number": "951-249-4693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28755 EL TORO RD",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925321912",
            "telephone_number": "951-249-4693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLICKHAHN",
        "first_name": "AMY",
        "middle_name": "LEIGH",
        "credential": "RN, BSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-12",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "CA",
            "license": "476931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Elsinore, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.