Individual
DONNA BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
712 CHINA ST, CROOKSVILLE, OH 43731-1124
(740) 697-0173
Mailing address
278 SMITH AVE, QUAKER CITY, OH 43773-9753
(740) 679-2929
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN319983
OH
Other
Enumeration date
12/22/2016
Last updated
12/22/2016
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