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Individual

ELYSE ANNE BLACKSTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
800 WAYNE ST STE 100, MARIETTA, OH 45750-3309
(740) 568-2214
(740) 568-2099
Mailing address
PO BOX 449, MARIETTA, OH 45750-0449

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN.CNP.024183
OH

Other

Enumeration date
03/06/2019
Last updated
05/09/2025
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