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Individual

MRS. BRENDA WOMACK BLACKMON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
300 W HOSPITAL ROAD 11C17 EAMC, ATTN OFFICE OF GRADUATE MEDICAL EDUCATION, FORT GORDON, GA 30905-5650
(706) 787-4657
(706) 787-1745
Mailing address
300 W HOSPITAL ROAD 11C17 EAMC, ATTN OFFICE OF GRADUATE MEDICAL EDUCATION, FORT GORDON, GA 30905-5650
(706) 787-4657
(706) 787-1745

Taxonomy

Speciality
Code
Description
License number
State
163WM0102X
Maternal Newborn Registered Nurse
Primary
RN141115
GA

Other

Enumeration date
06/06/2008
Last updated
06/06/2008
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