# BLAKENEY FAMILY PRACTICE, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Family First Wellness Practice
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629942388
- **Authorized official:** NIKITA BLAKENEY-WILLIAMS FNP-C (CNO)
- **Authorized official phone:** (980) 402-4668

## Contact information

- **Practice address:** 4401 E INDEPENDENCE BLVD STE 208F, CHARLOTTE, NC 28205-7485
- **Practice address phone:** (980) 402-4668
- **Mailing address:** PO BOX 37054, ROCK HILL, SC 29732-0517
- **Mailing address phone:** (980) 402-4668

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251J00000X | Nursing Care Agency | — | NULL | — |
| 261Q00000X | Clinic/Center | — | NULL | — |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/03/2025
- **Last updated:** 10/03/2025