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Individual
BRENT BLACKBURN
Active
Individual
BRENT BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E19988
AR
363LA2100X
Acute Care Nurse Practitioner
A004186
AR
Other
Enumeration date
08/22/2014
Last updated
10/28/2025
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