Individual
JAMIE RIVKIN BLALOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, APRN, FNP-C
Contact information
Practice address
15 EARNEST DR, BLAIRSVILLE, GA 30512-8627
(706) 745-8790
Mailing address
15 EARNEST DR, BLAIRSVILLE, GA 30512-8627
(706) 745-8790
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN149435
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003128313F
—
GA
Enumeration date
06/15/2012
Last updated
08/20/2019
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