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1770137044
MISTY BLACKBURN
COLUMBUS, IN
NPI
1770137044
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: IN 71009109A)
Enumeration Date
2019-07-25
Last Update Date
2020-11-02
Business Address
MISTY BLACKBURN NP
2502 25TH ST
COLUMBUS, IN 47201-3728
Phone number: 812-372-8883
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Mailing Address
MISTY BLACKBURN NP
PO BOX 775383
CHICAGO, IL 60677-5383
Phone number: 812-373-3000
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