Blackwood, Melissa Carol

Blackwood, Melissa Carol is an individual health care provider with primary practice located at 907 E Lamar Alexander Pkwy , Maryville TN 37804-5015. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Blackwood, Melissa Carol can be contacted via phone (865) 983-7211.

Contact Information

Primary practice address
907 E Lamar Alexander Pkwy Maryville TN 37804-5015
Phone: (865) 983-7211
Fax: (865) 983-8043
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X APN14537 Tennessee

Profile Details

NPI number 1043547524
LBN Legal business name Blackwood, Melissa Carol
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 4th, 2009
Last updated Aug 27th, 2019 - about 6 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 1043547524 NPPES
Tennessee Other 4246033 BLUE CROSS BLUE SHIELD TN
Tennessee MEDICAID 1516508 BLUE CROSS BLUE SHIELD TN

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