Blakeney, Susan E

Blakeney, Susan E is an individual health care provider with primary practice located at 415 S 28Th Ave , Hattiesburg MS 39401-7246. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Blakeney, Susan E can be contacted via phone (601) 268-5700.

Contact Information

Primary practice address
415 S 28Th Ave Hattiesburg MS 39401-7246
Phone: (601) 268-5700
Fax: (601) 268-5777
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X R724653 Mississippi
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 724653 Mississippi

Profile Details

NPI number 1891709572
LBN Legal business name Blakeney, Susan E
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 28th, 2006
Last updated Jul 23rd, 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 1891709572 NPPES
Mississippi MEDICAID 00122059

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