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Individual

LORI A BLACKBURN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PAC

Contact information

Practice address
305 N BELLWOOD RD, MORRISTOWN, TN 37814-1120
(423) 587-8300
(423) 289-1609
Mailing address
305 N BELLWOOD RD, MORRISTOWN, TN 37814-1120
(423) 587-8300
(423) 289-1609

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1739
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1521156
TN
Enumeration date
08/24/2006
Last updated
09/01/2020
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