Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Blaine Michael Kidd

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1700493483

Mr. Blaine Michael Kidd is a Student in an Organized Health Care Education/Training Program in West Lafayette, Indiana. Registered with an NPI since 2020.

In the registry since
2020
Specialties on file
2

Practice location Address checks out

900 N John R Wooden Dr
West Lafayette, IN 47907-2117
Phone: (800) 497-7678
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1700493483
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 28, 2020
Last updated in NPPESMay 26, 2023
Certification dateMay 26, 2023
Mailing address3426 Waverly Dr, Lafayette, IN 47909-7320

Other providers in West Lafayette