Individual
CRISTY MCMANUS BLACKMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
800 W MEETING ST, LANCASTER, SC 29720-2202
(803) 286-1214
Mailing address
PO BOX 603898, CHARLOTTE, NC 28260-3898
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
22931
SC
Other
Enumeration date
09/25/2019
Last updated
11/26/2019
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