Individual
PENNY KAY BLACKBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2250 HICKORY RD, SUITE 240, PLYMOUTH MEETING, PA 19462-1047
(317) 842-7674
(800) 334-9081
Mailing address
PO BOX 229, KINGMAN, IN 47952-0229
(765) 585-6000
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
27058294A
IN
Other
Enumeration date
10/15/2008
Last updated
10/15/2008
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