Individual
SHANNA NICHOLE BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1211 UNION AVE STE 965, MEMPHIS, TN 38104-6638
(901) 435-8550
(901) 478-0781
Mailing address
1211 UNION AVE STE 330, MEMPHIS, TN 38104-6655
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
36123
TN
Other
Enumeration date
05/22/2024
Last updated
07/23/2024
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