Sebrena Blacknall, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

61629 Issued in NC

Practice address

6118 Saint Giles St
Raleigh, NC 27612-7082

Phone

(919) 910-0441

Fax

(919) 341-5068

NPI assigned

Jul 1, 2024

Last updated

Jul 1, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1719792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1801631742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6118 SAINT GILES ST",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276127082",
            "telephone_number": "919-910-0441",
            "fax_number": "919-341-5068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6118 SAINT GILES ST",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276127082",
            "telephone_number": "919-910-0441",
            "fax_number": "919-341-5068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKNALL",
        "first_name": "SEBRENA",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-01",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NC",
            "license": "61629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tammy Blackard Cook, LCSW
• Jeffrey Robert Blackburn, MD
• Mallory Serpan Blackburn, OTR/L
• Marcia Michelle Blackmon Leveris, PHARMD
• Domonique Blackmon, M.S., LPCA
• Cole Blackwell, DC
• Danielle Blackwell, MS, LAT/ATC
• Erika Melissa Blackwell, CRNA
• Macy Blackwell, FNP
• Melvin Blackwell

• Licensed Practical Nurse in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Licensed Practical Nurse in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.