Individual
MARIBELLE M BLACKMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1226 PROGRESSIVE DR STE 101, CHESAPEAKE, VA 23320-2847
(757) 609-3301
Mailing address
1226 PROGRESSIVE DR STE 101, CHESAPEAKE, VA 23320-2847
(757) 609-3301
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024172045
VA
363LP2300X
Primary Care Nurse Practitioner
0024172045
VA
Other
Enumeration date
09/17/2014
Last updated
02/27/2020
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