Individual
LISA M BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNS
Contact information
Practice address
300 W 10TH AVE, COLUMBUS, OH 43210-1280
(614) 425-0257
(614) 293-6420
Mailing address
700 ACKERMAN RD, STE 570, COLUMBUS, OH 43202-1579
(614) 947-3700
Taxonomy
Speciality
Code
Description
License number
State
364S00000X
Clinical Nurse Specialist
Primary
NS05202 RN 204106
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2511400
—
OH
Enumeration date
10/18/2006
Last updated
01/10/2019
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