Bonita Jody Blackman, APRN, PMHNP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Bear, DE
NPI 1629956479 · NPPES record last updated Aug 22, 2025
Key facts
- NPI
- 1629956479
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- L8-0010711 (DE)
- Practice address
- 1148 Pulaski Hwy Ste 167
Bear, DE 19701-1305 - Phone
- (302) 373-8599
- NPI assigned
- Aug 21, 2025
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L8-0010711 | DE | MD | Psychiatric/Mental Health Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | L8-0010711 | DE | Yes |
Addresses
Primary practice location
1148 Pulaski Hwy Ste 167
Bear, DE 19701-1305
Mailing address
1148 Pulaski Hwy Ste 167
Bear, DE 19701-1305
Phone (302) 373-8599
Other providers in Bear, DE
- Samantha Benvenuto
- Better Wellness Family Practice LLC
- Christi L Betts
- Casey Marie Biddle
- Bio-Medical Applications of Delaware, Inc.
- Blesscare Home Caregivers LLC
- Carly Ann Block
- Alexander Nicholas Bohatiuk
- Brie Danielle Bolger
- Beverly Alvita Bond
All providers in Bear, DE · Psychiatric/Mental Health Nurse Practitioner in Delaware
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.