Individual
WEHTI BLACKLEDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15459 ANNAPOLIS RD, BOWIE, MD 20715-1847
(240) 544-0676
Mailing address
5000 COX RD, GLEN ALLEN, VA 23060-9263
(804) 968-5700
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
1025280
DC
363LF0000X
Family Nurse Practitioner
Primary
R166525
MD
Other
Enumeration date
10/20/2011
Last updated
02/11/2021
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