Sedadrian Santina Blaylock
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Newton, MS
NPI 1679254346 · NPPES record last updated Jul 26, 2023
Key facts
- NPI
- 1679254346
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 113 Tillman Ave
Newton, MS 39345-2741 - Phone
- (601) 663-5046
- NPI assigned
- Jul 26, 2023
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
113 Tillman Ave
Newton, MS 39345-2741
Mailing address
113 Tillman Ave
Newton, MS 39345-2741
Phone (601) 663-5046
Other providers in Newton, MS
- Mohammad Sohaib Arain
- Assurance Home Care Agency LLC
- Bedford Care Center of Newton, LLC
- Laticia Bickham
- Calli Boggan
- Bridges Health Clinic
- Allison B Brunson
- Shareen Buckner
- Central Mississippi Residential Center
All providers in Newton, MS · Student in an Organized Health Care Education/Training Program in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 26, 2023. 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.