Individual
KRISTINE BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
133 S 500 E, VERNAL, UT 84078-2728
(435) 247-1177
(435) 781-0538
Mailing address
133 S 500 E, VERNAL, UT 84078-2728
(435) 247-1177
(435) 781-0538
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
277462-3102
UT
Other
Enumeration date
12/08/2011
Last updated
12/08/2011
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