Individual
TAMMY FELICIA BLACKMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
270 17TH ST NW UNIT 2501, ATLANTA, GA 30363-1218
(678) 697-0844
Mailing address
270 17TH STREET STREET NW UNIT. 2501, ATLANTA, GA 30363
(678) 697-0844
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
RN196430
GA
Other
Enumeration date
07/17/2013
Last updated
07/17/2013
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