Blackburn, Derrick

Blackburn, Derrick is an individual health care provider with primary practice located at 909 Cushman St Ste 103 , Fairbanks AK 99701-4668. He recently has 4 registered licenses in different health care specialties including Other Service Providers / Case Manager/Care Coordinator, Nursing Service Related Providers / Chore Provider, Nursing Service Related Providers / Adult Companion, Nursing Service Related Providers / Day Training/Habilitation Specialist. Nursing Service Related Providers / Day Training/Habilitation Specialist is his primary health care specialty. Blackburn, Derrick can be contacted via phone (907) 456-4620.

Contact Information

Primary practice address
909 Cushman St Ste 103 Fairbanks AK 99701-4668
Phone: (907) 456-4620
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Case Manager/Care Coordinator 171M00000X
Nursing Service Related Providers / Chore Provider 372500000X
Nursing Service Related Providers / Adult Companion 372600000X
Nursing Service Related Providers / Day Training/Habilitation Specialist 373H00000X

Profile Details

NPI number 1104663715
LBN Legal business name Blackburn, Derrick
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 10th, 2024
Last updated Jul 10th, 2024 - about 5 months 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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