Elizabeth P Blackwood, NP
Nurse Practitioner in Austell, GA. Individual provider (NPI-1).
NPI number1528353364
StatusActive
Last updated in NPPESJun 9, 2011
Details
- NPI
- 1528353364
- Entity type
- Individual (NPI-1)
- Name
- Elizabeth P Blackwood
- Credential
- NP
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 9, 2011
- Last updated
- Jun 9, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | RN144610 | GA | Yes |
Other names
- Elizabeth Pangman (Former Name)
Practice location
3950 Austell RdAustell, GA 30106-1121
Phone 770-732-7000
Mailing address
5665 New Northside Dr NwSuite 320
Atlanta, GA 30328-5831
Phone 770-874-5468 · Fax 770-874-5469
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