TARA DESHEE BLACKWELL

PADUCAH, KY
NPI1326265430
Former NameTARA DESHEE HILDRETH
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LW0102X Nurse Practitioner, Women's Health
(Licence: KY  3005131)
Additional Taxonomies363LF0000X Nurse Practitioner, Family
(Licence: KY  3005131)
Enumeration Date2007-04-19
Last Update Date2021-03-05
Business Address
TARA DESHEE BLACKWELL APRN
2605 KENTUCKY AVE STE. 102
PADUCAH, KY 42003-3800
Phone number: 270-415-8965
Mailing Address
TARA DESHEE BLACKWELL APRN
PO BOX 776351
CHICAGO, IL 60677-6351
Phone number: 502-588-9490