BLAKELY EDMUND (NPI# 1083148522) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083148522 |
| Entity Type | Individual |
| Full Name | BLAKELY EDMUND |
| Credential | APRN |
| Practice Address |
4301 W Markham St Breast Cancer Clinic Little Rock AR 72205-7101 |
| Mailing Address |
4301 West Markham Street Breast Cancer Clinic Little Rock AR 72205 |
| Practice Telephone | 5018134885 |
| Mailing Telephone | 5018134885 |
| Enumeration Date | 2017-04-11 |
| Last Update Date | 2017-04-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SF0001X |
Clinical Nurse Specialist Specialization: Family Health |
A005123 | AR | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4301 W MARKHAM ST BREAST CANCER CLINIC |
| City | LITTLE ROCK |
| State | AR |
| Zip Code | 72205-7101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811998487 | Jan K Hastings | Pharmacist | 4301 W Markham St, #522, Little Rock, AR 72205-7101 | 2005-08-04 |
| 1043810971 | Prashanth Reddy Damalcheruvu | Student in an Organized Health Care Education/Training Program | 4301 W Markham St, Little Rock, AR 72205-7199 | 2020-10-29 |
| 1114533619 | Nitesh Gautam | Student in an Organized Health Care Education/Training Program | 4301 W Markham St, Little Rock, AR 72205-7101 | 2020-09-20 |
| 1891301818 | Rachel Rosenbaum | Nurse Practitioner | 4301 W Markham St, Little Rock, AR 72205-7101 | 2020-09-16 |
| 1477164861 | Ashtyn Leann Knowles | Dietitian, Registered | 4301 W Markham St, Little Rock, AR 72205-7101 | 2020-08-11 |
| 1700404118 | Candace Johnson | Social Worker | 4301 W Markham St, Little Rock, AR 72205-7101 | 2020-07-12 |
| 1851919245 | Omar Alqaisi | Student in an Organized Health Care Education/Training Program | 4301 W Markham St, Little Rock, AR 72205-7101 | 2020-07-11 |
| 1295364578 | Julie Michelle Nessler | Student in an Organized Health Care Education/Training Program | 4301 W Markham St, Little Rock, AR 72205-7101 | 2020-04-07 |
| 1346879079 | Brian Wesley Rhea | Student in an Organized Health Care Education/Training Program | 4301 W Markham St, Little Rock, AR 72205-7199 | 2020-04-04 |
| 1265060388 | Erin Elizabeth Hall | Student in an Organized Health Care Education/Training Program | 4301 W Markham St, Slot 517, Little Rock, AR 72205-7101 | 2020-04-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932719465 | Darleisha Renee Stigall | Behavior Technician | 1210 Aldersdate Rd, Little Rock, AR 72205 | 2020-08-10 |
| 1316563638 | Unknown Amisha | Student in an Organized Health Care Education/Training Program | 4301 West Markham St, Slot #634, University of Arkansas, Little Rock, AR 72205 | 2020-06-23 |
| 1225667272 | Ann-marie Frances Hayre | Student in an Organized Health Care Education/Training Program | 4310 West Markham, Slot 589, Little Rock, AR 72205 | 2020-04-02 |
| 1952930075 | Alexandria Leigh Smith | Student in an Organized Health Care Education/Training Program | 4301 West Markham St, Slot 531, Little Rock, AR 72205 | 2020-04-02 |
| 1093353922 | Phil Fagala | Pharmacist | 614 North Beechwood, Little Rock, AR 72205 | 2019-12-10 |
| 1295391688 | Home To Community Living, Inc | Physical Therapist | 10201 W Markham Street Pulaski, Little Rock, AR 72205 | 2019-05-12 |
| 1669933693 | Sandy Louise Webb | Student in an Organized Health Care Education/Training Program | 4301 West Markham, Slot 530, Little Rock, AR 72205 | 2019-03-31 |
| 1457812828 | Vincent Battafarano | Student in an Organized Health Care Education/Training Program | 4301 West Markham, Slot 602, Little Rock, AR 72205 | 2019-03-28 |
| 1063978922 | Franks Pediatric Occupational Therapy LLC | Occupational Therapist | 5516 C St, Little Rock, AR 72205 | 2019-02-15 |
| 1497210199 | Integrative Counseling Center LLC | Counselor | 10515 W Markham St Ste D3, Little Rock, AR 72205 | 2019-02-06 |
| Find all providers in zip 72205 | ||||
| Taxonomy Code | 364SF0001X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Family Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336699941 | Michelle Kathleen Auld | Clinical Nurse Specialist | 120 Adcock Rd, Suite D, Hot Springs, AR 71913-8184 | 2016-10-06 |
| 1407209075 | Mirenda Martin | Clinical Nurse Specialist | 507 N Main Street, Salem Family Clinic 507 N Main Street, Salem, AR 72576 | 2016-07-19 |
| 1023461076 | Linda Dukes | Clinical Nurse Specialist | 3564 Albert Pike Rd, Hot Springs, AR 71913-9542 | 2016-07-14 |
| 1295104578 | Excel Health of Haskell, Pllc | Clinical Nurse Specialist | 6029 Us Hwy 67, Haskell, AR 72015 | 2015-09-17 |
| 1720482482 | Ozark Wellness Clinic Pllc | Clinical Nurse Specialist | 102 W College St, Ozark, AR 72949-2850 | 2014-10-09 |
| 1376538090 | Marie Pham-russell | Clinical Nurse Specialist | 3202 N 6th St, Fort Smith, AR 72904-4164 | 2005-09-19 |
| 1114534369 | Madison Birdno | Clinical Nurse Specialist | 303 E Matthews Ave Ste 202, Jonesboro, AR 72401-3120 | 2020-09-30 |
| 1356884647 | Stephanie Hulett | Clinical Nurse Specialist | 700 S 52nd St, Rogers, AR 72758-8605 | 2016-11-18 |
| 1346693710 | Jennifer Sue Conry Jones | Clinical Nurse Specialist | 180 Medical Park Pl, Ste. 101, Hot Springs, AR 71901-8065 | 2016-07-20 |
| 1104293018 | Jillian Harris | Clinical Nurse Specialist | 1605 2nd St, Earle, AR 72331-1634 | 2015-08-26 |
| Find all providers with the same taxonomy | ||||
| City | LITTLE ROCK |
| Zip Code | 72205 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.