Individual
ANN ELIZABETH BLACKWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N,
Contact information
Practice address
505 W SAN JUAN DR, BLOOMINGTON, IN 47403-4385
(812) 320-1852
Mailing address
505 W SAN JUAN DR, APT/SUITE, BLOOMINGTON, IN 47403-4385
(812) 320-1852
Taxonomy
Speciality
Code
Description
License number
State
163WM0102X
Maternal Newborn Registered Nurse
Primary
28158668A
IN
Other
Enumeration date
01/18/2013
Last updated
01/18/2013
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