Individual
MRS. TANIKA BLACKMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
5412 APPLE GLEN DR, HARRISBURG, NC 28075-8772
(704) 222-5702
Mailing address
5412 APPLE GLEN DR, HARRISBURG, NC 28075-8772
(704) 222-5702
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
9999
NC
Other
Enumeration date
12/04/2018
Last updated
12/04/2018
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