Amy Blackledge, RN

Primary specialty

Ambulatory Care Registered NurseTaxonomy code 163WP2201X

License

41313 Issued in ID

Practice address

3250 W Cherry LN
Meridian, ID 83642-1120

Phone

(208) 302-6404

NPI assigned

Jun 5, 2020

Last updated

Jun 5, 2020By the provider in NPPES

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

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": "1591315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591315200000",
    "number": "1386268332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 W SCREECH OWL DR",
            "city": "KUNA",
            "state": "ID",
            "postal_code": "836343528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3250 W CHERRY LN",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836421120",
            "telephone_number": "208-302-6404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKLEDGE",
        "first_name": "AMY",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-05",
        "last_updated": "2020-06-05",
        "certification_date": "2020-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "ID",
            "license": "41313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Ann Black, LPC
• Isaac Black
• Nicole Black
• Tarah Black, INHC
• Samantha D'Ann Blackburn, PMHNP-BC; FNP-C
• Blackmer Podiatry
• Blackrock Orthopedic Specialists LLC
• Lacee Danielle Blackstone
• Chad Blair
• Randall Parley Blair, DMD

• Ambulatory Care Registered Nurse in Meridian, ID
• Providers in Meridian, ID by specialty
• Ambulatory Care Registered Nurse in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2020; 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.