Individual
KELLIE BLACKWELDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
601 CHILDRENS LN, NORFOLK, VA 23507-1910
(757) 668-7000
Mailing address
120 KENNETH CT, NEWPORT NEWS, VA 23602-6560
(757) 813-5699
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
0001286260
VA
Other
Enumeration date
09/22/2021
Last updated
09/22/2021
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