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Individual

MELISSA CAROL BLACKWOOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
907 E LAMAR ALEXANDER PKWY, MARYVILLE, TN 37804-5015
(865) 977-5760
(865) 977-4788
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APN14537
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1516508
TN
01
4246033
BLUE CROSS BLUE SHIELD TN
TN
05
Q047344
TN
Enumeration date
11/04/2009
Last updated
11/25/2025
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