Blackburn, Lori A

Blackburn, Lori A is an individual health care provider with primary practice located at 305 N Bellwood Rd , Morristown TN 37814-1120. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Blackburn, Lori A can be contacted via phone (423) 587-8300.

Contact Information

Primary practice address
305 N Bellwood Rd Morristown TN 37814-1120
Fax: (423) 289-1609
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 1739 Tennessee

Profile Details

NPI number 1780791749
LBN Legal business name Blackburn, Lori A
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 24th, 2006
Last updated Sep 1st, 2020 - about 4 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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Identifiers

StateTypeNumberIssuer
All States NPI 1780791749 NPPES
Tennessee MEDICAID 1521156

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