Blackard, Katrina Marie
Blackard, Katrina Marie is an individual health care provider with primary practice located at 401 Southcrest Cir Ste 212 , Southaven MS 38671-6721. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Primary Care, which is considered as her primary health care specialty. Blackard, Katrina Marie can be contacted via phone (662) 349-0488.Contact Information
Primary practice address
401 Southcrest Cir Ste 212
Southaven MS 38671-6721
Phone: (662) 349-0488
Fax: (662) 349-5974
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Primary Care | 363LP2300X | 28617 | Tennessee |
| Physician Assistants & Advanced Practice Nursing Providers / Primary Care | 363LP2300X | 904313 | Mississippi |
Profile Details
| NPI number | 1467051029 |
|---|---|
| LBN Legal business name | Blackard, Katrina Marie |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 23rd, 2020 |
| Last updated | Jul 13th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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