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Individual

KAITLIN ANN BLACKBURN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
118 SHEPHERD LANE, CRAB ORCHARD, WV 25827
(304) 860-1253
Mailing address
PO BOX 365, CRAB ORCHARD, WV 25827-0365
(304) 860-1253

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
TEMP00924
WV

Other

Enumeration date
06/25/2009
Last updated
06/25/2009
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