Individual
ANTOINETTE BLACKSTOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1333 CHESTNUT AVE, LONG BEACH, CA 90813-2944
(562) 753-2301
Mailing address
64 MONROE, IRVINE, CA 92620-3639
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
Primary
95039382
CA
Other
Enumeration date
12/30/2022
Last updated
12/30/2022
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