Individual
MS. REBECCA ANN BLACKBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
3500 S LAFOUNTAIN ST, KOKOMO, IN 46902-3803
(765) 453-8352
(765) 453-8457
Mailing address
3500 S LAFOUNTAIN ST, P.O. BOX 9011, KOKOMO, IN 46902-3803
(765) 453-8352
(765) 453-8457
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
37001345A
IN
Other
Enumeration date
12/20/2006
Last updated
07/09/2007
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