Individual
MISTY BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3015 10TH ST STE A, COLUMBUS, IN 47201-7091
(812) 372-8883
(812) 373-3265
Mailing address
PO BOX 775383, CHICAGO, IL 60677-5383
(812) 376-5315
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71009109A
IN
Other
Enumeration date
07/25/2019
Last updated
03/26/2026
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