Individual
JACQUELYN A BLACKSTONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
4701 MONTGOMERY BLVD NE, ALBUQUERQUE, NM 87109-1219
(505) 727-6853
Mailing address
4101 INDIAN SCHOOL RD NE STE 110, ALBUQUERQUE, NM 87110-3991
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
A-1954-16
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
289980099
—
ME
05
—
30005994
—
NH
Enumeration date
01/11/2007
Last updated
10/29/2025
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