Individual
DEBORAH A BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, RN, FNP-C
Contact information
Practice address
1 JEFFERSON BARRACKS RD, SAINT LOUIS, MO 63125-4181
(314) 652-4100
(314) 894-6594
Mailing address
240 BIRCHLAWN DR, FLORISSANT, MO 63033-6333
(314) 607-8777
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
123558
MO
163WD1100X
Peritoneal Dialysis Registered Nurse
123558
MO
163WN0300X
Nephrology Registered Nurse
123558
MO
363L00000X
Nurse Practitioner
Primary
123558
MO
363LF0000X
Family Nurse Practitioner
123558
MO
Other
Enumeration date
09/24/2008
Last updated
03/18/2024
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