Individual
SHAYLA MARIE BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
601 HIGHWAY 6 W, IOWA CITY, IA 52246-2209
(319) 338-0581
(319) 688-3587
Mailing address
2708 N COUNTY ROAD 1500, NIOTA, IL 62358-2112
(217) 755-4387
(217) 755-4387
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043067363
IL
164W00000X
Licensed Practical Nurse
P28748
IA
Other
Enumeration date
09/21/2012
Last updated
09/21/2012
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