Elena Victorovna Blackburn, SRNA, MBA, BSN, CCRN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

R253634 Issued in MD

Practice address

1800 Orleans St
Baltimore, MD 21287-0010

Phone

(410) 955-5000

NPI assigned

Oct 13, 2022

Last updated

Oct 17, 2022By 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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Master of Business Administration

State licenses

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

{
    "created_epoch": "1665619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1578289369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6537 FERN ST",
            "city": "NAVARRE",
            "state": "FL",
            "postal_code": "325668045",
            "telephone_number": "509-607-8893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 ORLEANS ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870010",
            "telephone_number": "410-955-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "525 N Wolfe St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212052110",
            "country_code": "US",
            "telephone_number": "410-955-4766",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACKBURN",
        "first_name": "ELENA",
        "middle_name": "VICTOROVNA",
        "credential": "SRNA, MBA, BSN, CCRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-13",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R253634",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN",
            "identifier": "R253634",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eblackb2@jh.edu",
            "affiliation": "N",
            "endpointDescription": "school email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1800 Orleans St",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212870010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Maya Black
• Rachael Ann Wilson Black
• Rachel Catherine Black, FNP
• Samuel Black
• Denise Nanette Blackbourne, PA-C
• Judith Blackburn, PH.D.
• Mason Alan Blackburn, CGC
• Sarah Kelsey Blackert
• Gabrielle Levine Blackman, M.D.
• Isabella Caroline Blackman

• Registered Nurse in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Registered Nurse in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2022; 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.