Individual
JENNIFER E BLACKMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1325 NE 7TH ST, GRANTS PASS, OR 97526-1358
(541) 460-5331
(541) 460-5165
Mailing address
1325 NE 7TH ST, GRANTS PASS, OR 97526-1358
(541) 460-5331
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
10016379
OR
363LF0000X
Family Nurse Practitioner
AP145410
TX
Other
Enumeration date
03/19/2020
Last updated
02/06/2025
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