Individual
NADINE BLACKBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
24281 POSTAL AVE, 211, MORENO VALLEY, CA 92553-3093
(951) 488-9111
(480) 773-8616
Mailing address
PO BOX 1013, MORENO VALLEY, CA 92556-1013
(951) 488-9111
(480) 445-9790
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
15582
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
330620945
VA
CA
Enumeration date
08/03/2006
Last updated
04/20/2009
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