Individual
CASEY MARIE BLACKWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
555 W STATE ROAD 434, LONGWOOD, FL 32750-5119
(321) 842-8505
(321) 843-5550
Mailing address
487 S BLUFORD AVE, OCOEE, FL 34761-2748
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
11035131
FL
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN11035131
FL
Other
Enumeration date
11/08/2024
Last updated
12/24/2024
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