Blackwell, Cory F

Blackwell, Cory F is an individual health care provider with primary practice located at 2341 Mccallie Ave Suite 402, Chattanooga TN 37404-3239. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Blackwell, Cory F can be contacted via phone (423) 698-3309.

Contact Information

Primary practice address
2341 Mccallie Ave Suite 402 Chattanooga TN 37404-3239
Phone: (423) 698-3309
Fax: (423) 624-6355
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X RN103349 Tennessee
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X APN09974 Tennessee
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X RN111991 Georgia

Profile Details

NPI number 1689640518
LBN Legal business name Blackwell, Cory F
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 28th, 2006
Last updated Apr 9th, 2019 - about 5 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 1689640518 NPPES
Tennessee Other 4059111 BCBS
Tennessee MEDICAID 3626058 BCBS

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