Individual
MRS. MICHELLE BLACKSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1105 N POINT BLVD STE 321, BALTIMORE, MD 21224-3472
(410) 517-7060
(443) 407-2942
Mailing address
1105 N POINT BLVD STE 321, BALTIMORE, MD 21224-3472
(410) 517-7060
(443) 407-2942
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R160398
MD
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
R160398
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
783304100
—
MD
Enumeration date
10/25/2016
Last updated
01/26/2023
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