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NANCY ANN BLACKETER FNP
>> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1518152925
Individual Registrant: NANCY ANN BLACKETER FNP
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
3102 EAST HIGHLAND AVE PATTON, CA 92369 US
Tel: 909-425-7000 Fax: 909-425-7520
Tel: 909-425-7000 Fax: 909-425-7520
Contact information for business:
1600 9TH STREET ROOM 205 MAILSTOP 2-3 SACRAMENTO, CA 95814-6414 US
Tel: 916-654-2431 Fax: 916-654-3186
Tel: 916-654-2431 Fax: 916-654-3186
Registration Information:
NPI: 1518152925
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | CA | RN11513 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
