Cassandra Blackmon, RN
Individual provider Active NPI Registered Nurse · Memphis, TN
NPI 1639313992 · NPPES record last updated Apr 29, 2009
Key facts
- NPI
- 1639313992
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 162463 (TN)
- Practice address
- 3810 Winchester Rd
Southeast Mental Health Center
Memphis, TN 38118-6045 - Phone
- (901) 369-1400
- Fax
- (901) 369-1433
- NPI assigned
- Apr 29, 2009
- 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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 162463 | TN | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 162463 | TN | Yes |
Addresses
Primary practice location
3810 Winchester Rd
Southeast Mental Health Center
Memphis, TN 38118-6045
Mailing address
1885 Wall St Apt 8
Memphis, TN 38134-9618
Phone (901) 907-0035
Other providers in Memphis, TN
- Dexter Cornelius Blackburn
- Ryan Blackburn
- Tyler Ansley Blackburn
- Melrose Ingle Blackett
- Tomandra Blackman
- Celisa Rufus Blackmon
- Victoria Elise Blackmon
- Yolanda Ravon Blackmon
- Amber Blackshear
- Taneshia Blackshire
All providers in Memphis, TN · Registered Nurse in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 29, 2009. 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.