Individual
MRS. CAROLYN I BLACKMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
853 BATTLECREEK RD, JONESBORO, GA 30236-1919
(770) 478-1099
(770) 478-8722
Mailing address
2310 VILLA POINT PKWY, MCDONOUGH, GA 30253-9239
(678) 836-8874
(770) 478-8722
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN083571
GA
Other
Enumeration date
02/22/2012
Last updated
02/22/2012
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