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CHRISTY ELLEN BLACKBURN NP

Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1255974150

Individual Registrant:
 CHRISTY ELLEN BLACKBURN NP
Gender: F
Not Sole Proprietor

Location and contact information for practice:
3651 SE 97TH LN  BELLEVIEW, FL 34420-7800 US
Tel: 352-342-6985  Fax: --

Contact information for business:
3651 SE 97TH LN  BELLEVIEW, FL 34420-7800 US
Tel: 352-342-6985  Fax: --

Registration Information:
NPI: 1255974150
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Family
FL11004767

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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