Individual
MRS. SANDRA BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
27991 CENTER RIDGE RD, WESTLAKE, OH 44145-3902
(440) 250-0424
Mailing address
2220 BUNTS RD, LAKEWOOD, OH 44107-6106
(440) 258-4909
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
020836
OH
Other
Enumeration date
06/18/2017
Last updated
06/18/2017
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