Individual
NYREE BLACKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2694 HIGHWAY 20 NE, CONYERS, GA 30012-2217
(757) 803-0081
Mailing address
2694 HIGHWAY 20 NE, CONYERS, GA 30012-2217
(757) 803-0081
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05
—
GA
05
—
7578030081
—
GA
Enumeration date
01/20/2022
Last updated
01/20/2022
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