Individual
JENNIFER BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPAS, PA-C
Contact information
Practice address
4200 LAKE OTIS PKWY STE 303, ANCHORAGE, AK 99508-5226
(907) 600-5212
(907) 600-1026
Mailing address
4200 LAKE OTIS PKWY STE 303, ANCHORAGE, AK 99508-5226
(907) 600-5212
(907) 600-1026
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
239153
AK
363AM0700X
Medical Physician Assistant
PA.0006063
CO
363AM0700X
Medical Physician Assistant
PA8212
MA
Other
Enumeration date
10/29/2015
Last updated
10/01/2025
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