# MICHELLE ELAINE BLACKWOOD

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1417971912
- **Gender:** F
- **Credential:** APRN-CNP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WN0002X | Neonatal Intensive Care Registered Nurse | 028145 | IL | — |
| 363L00000X | Nurse Practitioner | SP028660 | PA | — |
| 363LF0000X | Family Nurse Practitioner | 028145 | IL | — |
| 363LN0000X | Neonatal Nurse Practitioner | 11733 | TN | — |
| 363LN0000X | Neonatal Nurse Practitioner | 217686 | OK | Yes |
| 363LN0000X | Neonatal Nurse Practitioner | 225161 | LA | — |

## Other

- **Enumeration date:** 07/27/2006
- **Last updated:** 01/28/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 620476822 | VMG TAX ID | TN |