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Individual
MRS. VICKIE C BLACKBURN
Active
Individual
MRS. VICKIE C BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2650
SC
363L00000X
Nurse Practitioner
5014444
NC
363LA2100X
Acute Care Nurse Practitioner
2650
SC
Other
Enumeration date
06/01/2005
Last updated
07/09/2026
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