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Individual

CRYSTAL BLACKBURN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
120 PROSPEROUS PL STE 201, LEXINGTON, KY 40509-1866
(859) 368-0609
(859) 368-9767
Mailing address
145 SEVEN OAKS DR, RICHMOND, KY 40475-8058

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1152860
KY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4001215
KY

Other

Enumeration date
03/21/2022
Last updated
01/14/2025
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