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Individual
NAOMI KAY BLACKBURN
Active
Individual
NAOMI KAY BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N., C.N.P.
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
COA.10506-NP
OH
363LF0000X
Family Nurse Practitioner
RN241001
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003908930
FACILITY NPI #
—
05
—
2954272
—
OH
05
—
7100086520
—
KY
01
—
RN241001
LICENSE NUMBER
OH
Enumeration date
01/14/2009
Last updated
06/16/2020
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