Individual
ANGELA YVETTE BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPNP
Contact information
Practice address
615 RIDGE RD, ROXBORO, NC 27573-4629
(336) 503-5623
Mailing address
5213 S ALSTON AVE, DURHAM, NC 27713-4430
(919) 620-4855
(919) 620-4921
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
5011847
NC
363L00000X
Nurse Practitioner
Primary
5011847
NC
Other
Enumeration date
06/10/2019
Last updated
08/20/2020
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