Individual
MRS. CAROL ANN BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
263 RIDGEFIELD RD, ENDICOTT, NY 13760-4256
(607) 757-2154
Mailing address
263 RIDGEFIELD RD, ENDICOTT, NY 13760-4256
(607) 757-2152
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
290020
NY
Other
Enumeration date
10/03/2017
Last updated
10/03/2017
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