Individual
MAURICE ELLIS BLACKBIRD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN, FNP-BC
Contact information
Practice address
100 INDIAN HILLS DR, MACY, NE 68039-3023
(402) 837-5381
(402) 837-5303
Mailing address
PO BOX 213, ROSALIE, NE 68055-0213
(712) 635-5459
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
114952
NE
Other
Enumeration date
11/01/2023
Last updated
11/01/2023
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