Individual
TANASA MARIA BLACKSHEAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
261 CONNECTICUT DR STE 5, BURLINGTON, NJ 08016-4177
(800) 950-6066
Mailing address
404 LAKE BLVD, LINDENWOLD, NJ 08021-3313
(856) 784-3958
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
26NP01143000
NJ
Other
Enumeration date
04/16/2007
Last updated
07/08/2007
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