Donnetta Kay Blackmon
Individual provider Active NPI Case Manager/Care Coordinator · Moraine, OH
NPI 1780188029 · NPPES record last updated Mar 21, 2018
Key facts
- NPI
- 1780188029
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- Practice address
- 3095 Kettering Blvd
Moraine, OH 45439-1983 - Phone
- (937) 293-8300
- Fax
- (937) 534-1350
- NPI assigned
- Mar 21, 2018
- 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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Yes |
Addresses
Primary practice location
3095 Kettering Blvd
Moraine, OH 45439-1983
Mailing address
3095 Kettering Blvd
Moraine, OH 45439-1983
Phone (937) 293-8300
Other providers in Moraine, OH
- Samuel Beyene
- Margaret Shea Bianchi
- Sara Bierly
- Rachel Bird
- Albine Bizimana
- Blackstone Healthcare, Inc.
- Hannah Blair
- Ciara Nicole Blake
- Michael Kent Blosser
- Keymariah Boatman
All providers in Moraine, OH · Case Manager/Care Coordinator in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 21, 2018. 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.