Individual
BREANNA BLACKLEDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
61 MEMORIAL MEDICAL PKWY STE 2811, PALM COAST, FL 32164-5999
(386) 586-1955
(386) 586-1959
Mailing address
61 MEMORIAL MEDICAL PKWY STE 2811, PALM COAST, FL 32164-5999
(386) 586-1955
(386) 586-1959
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN11044029
FL
Other
Enumeration date
02/06/2026
Last updated
02/06/2026
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