Individual
RANDY BLACKMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
105 W GRIGGS AVE, LAS CRUCES, NM 88001-1235
(575) 647-2800
Mailing address
385 CALLE DE ALEGRA, BLDG A, LAS CRUCES, NM 88005-3423
(575) 526-1105
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
557317
TX
Other
Enumeration date
05/23/2016
Last updated
05/23/2016
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