Individual
SELENA BLACKBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6842 QUANTUM CT, SPARKS, NV 89436-7167
(360) 431-7827
Mailing address
6842 QUANTUM CT, SPARKS, NV 89436-7167
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
RN00116502
WA
163WE0003X
Emergency Registered Nurse
Primary
RN66436
NV
Other
Enumeration date
04/23/2014
Last updated
04/23/2014
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