Jennifer Ann Blackburn, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

747131 Issued in CA

Practice address

4129 E Ocean Blvd Apt 204
Long Beach, CA 90803-2827

Phone

(562) 434-6564

NPI assigned

Dec 22, 2009

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Jennifer Ann Marlatt Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1261440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261440000000",
    "number": "1114256153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4129 E OCEAN BLVD APT 204",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908032827",
            "telephone_number": "562-434-6564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4129 E OCEAN BLVD APT 204",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908032827",
            "telephone_number": "562-434-6564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKBURN",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-22",
        "last_updated": "2009-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "747131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "MARLATT",
            "middle_name": "ANN",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jaleesa Black
• James M Black, PA
• Mary Ann Black, LCSW
• Pegi Black, NP
• Tracy Black
• Carol Anne Blackmon, RN PHN
• Roger Blackshear
• Heather Blackshire
• Antoinette Blackstock, RN
• Rachel E Blaine, DSC, MPH, RDN

• Registered Nurse in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.