Blackmon, Bettie

Blackmon, Bettie is an individual health care provider with primary practice located at 11990 Jackson St , Clinton LA 70722-3210. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Blackmon, Bettie can be contacted via phone (225) 683-5292.

Contact Information

Primary practice address
11990 Jackson St Clinton LA 70722-3210
Phone: (225) 683-5292
Fax: (225) 683-3411
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X AP03903 Louisiana

Profile Details

NPI number 1356344949
LBN Legal business name Blackmon, Bettie
Credentials FNP-C
Entity Individual
Sole proprietor 1 No
Enumeration date May 27th, 2005
Last updated Mar 7th, 2023 - about last year

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 1356344949 NPPES
Louisiana MEDICAID 1114367

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