Jean D Blackmon, RN
Registered Nurse, Urology in Mt Pleasant, SC. Individual provider (NPI-1).
NPI number1205411766
StatusActive
Last updated in NPPESMar 16, 2021
Details
- NPI
- 1205411766
- Entity type
- Individual (NPI-1)
- Name
- Ms. Jean D Blackmon
- Credential
- RN
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 16, 2021
- Certification date
- Mar 16, 2021
- Last updated
- Mar 16, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163WU0100X | Registered Nurse, Urology | 104325 | SC | Yes |
Practice location
1551 Ben Sawyer Blvd Unit 5gMt Pleasant, SC 29464-5508
Phone 843-367-9938
Mailing address
1551 Ben Sawyer Blvd Unit 5gMt Pleasant, SC 29464-5508
Phone 843-367-9938
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