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MS. ROSALIE DELANEY BLACKWELL LM, CPM

>> Midwife >> Other Service Providers

Registrant NPI Number: 1013595503

Individual Registrant:
MS. ROSALIE DELANEY BLACKWELL LM, CPM
Gender: F
Not Sole Proprietor

Location and contact information for practice:
2010 EVERGREEN AVE SW  LIVE OAK, FL 32064-4421 US
Tel: 386-466-8404  Fax: 800-853-5087

Contact information for business:
2010 EVERGREEN AVE SW  LIVE OAK, FL 32064-4421 US
Tel: 386-466-8404  Fax: 800-853-5087

Registration Information:
NPI: 1013595503
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y176B00000XOther Service Providers
Midwife
FLMW404

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
STATE LICENSE NUMBERMW404FL01




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