Individual
MS. DENISE NANETTE BLACKBOURNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4470 REGENCY PL, WHITE PLAINS, MD 20695-3085
(240) 252-2140
Mailing address
4470 REGENCY PL, WHITE PLAINS, MD 20695-3085
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
C0007330
MD
Other
Enumeration date
09/09/2011
Last updated
12/09/2025
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