Individual
JOHN BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
611 BELMONT AVE, YOUNGSTOWN, OH 44502-1037
(330) 744-2991
Mailing address
3165 CLEARWATER ST NW, WARREN, OH 44485-2217
(330) 974-7240
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN.CNP.025081
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2488400
—
OH
Enumeration date
09/27/2016
Last updated
07/24/2019
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