Individual
SHARONE MARIE BLACKBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
273 E BEVERLY BLVD, MONTEBELLO, CA 90640-3775
(323) 724-5100
Mailing address
3000 GOFFS FALLS RD, MANCHESTER, NH 03103-6109
(800) 995-2673
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
694107
CA
Other
Enumeration date
11/12/2018
Last updated
11/12/2018
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