Rosalind Blackmon

Individual provider Active NPI Registered Nurse · Ft. Gordon, GA

NPI 1700213816 · NPPES record last updated Oct 3, 2013

Key facts

NPI
1700213816
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
RN160138 (GA)
Practice address
300 Hospital Rd
Ft. Gordon, GA 30905
Phone
(706) 787-8290
NPI assigned
Oct 3, 2013
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
RN160138GAMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN160138 GA Yes

Addresses

Primary practice location

300 Hospital Rd
Ft. Gordon, GA 30905

Mailing address

300 Hospital Rd
Ft. Gordon, GA 30905
Phone (706) 787-8290

Other providers in Ft. Gordon, GA

All providers in Ft. Gordon, GA · Registered Nurse in Georgia

Sources for this page

Verify at the official NPI Registry.