Individual
MARY BLACKMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
7917 MACKINAW TRL, CADILLAC, MI 49601-9746
(231) 779-9700
Mailing address
PO BOX 963, CADILLAC, MI 49601-0963
(231) 779-9700
(231) 775-0027
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704116038
MI
Other
Enumeration date
04/23/2010
Last updated
04/23/2010
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