Individual
MS. JACQUELINE BETH BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
2018 WESTERN AVE, KNOXVILLE, TN 37921-5718
(865) 544-0406
(865) 544-0480
Mailing address
1923 SULPHUR SPRINGS RD, MORRISTOWN, TN 37813-5654
(423) 317-9344
(423) 714-2355
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
AP134132
TX
363LF0000X
Family Nurse Practitioner
Primary
APN22416
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3787640-01
—
TX
01
—
AP134132
TEXAS BOARD OF NURSING
TX
01
—
F01171364
AMERICAN ACADEMY OF NURSE PRACTITIONERS-CERTIFICATION BOARD
TX
Enumeration date
06/18/2017
Last updated
06/27/2022
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