Vickie C Blackburn, NP
Nurse Practitioner in Rock Hill, SC. Individual provider (NPI-1).
NPI number1487656708
StatusActive
Last updated in NPPESJul 9, 2026
Details
- NPI
- 1487656708
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Vickie C Blackburn
- Credential
- NP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 1, 2005
- Certification date
- Jul 9, 2026
- Last updated
- Jul 9, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | 2650 | SC | Yes |
| 363LA2100X | Nurse Practitioner, Acute Care | 2650 | SC | |
| 363L00000X | Nurse Practitioner | 5014444 | NC |
Practice location
1721 Ebenezer Rd Ste 175Rock Hill, SC 29732-1188
Phone 803-324-5256 · Fax 803-328-0440
Mailing address
Po Box 604350Charlotte, NC 28260-4350
Phone 704-364-8100 · Fax 704-365-2073
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