Individual
KATRINA LINETTE BLACKWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6134 GOLD WORTHY CT, CHARLOTTE, NC 28212-6999
(704) 207-1333
Mailing address
6134 GOLD WORTHY CT, CHARLOTTE, NC 28212-6999
(704) 207-1333
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
234128
NC
163WC1600X
Continuing Education/Staff Development Registered Nurse
234128
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982921227
—
NC
Enumeration date
06/12/2019
Last updated
06/12/2019
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