ANGELA BLACKBURN (NPI# 1457892853) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457892853 |
| Entity Type | Individual |
| Full Name | ANGELA BLACKBURN |
| Credential | NP |
| Practice Address |
31208 Day Lily Dr Brownstown MI 48173-8768 |
| Mailing Address |
31208 Daylilly Dr Brownstown MI 48173 |
| Practice Telephone | 7343580436 |
| Mailing Telephone | 7343580436 |
| Enumeration Date | 2017-03-17 |
| Last Update Date | 2017-04-26 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 44704205566 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245899616 | Angela Yvette Blackburn | Hospitalist | 615 Ridge Rd, Roxboro, NC 27573-4629 | 2019-06-10 |
| 1225114143 | Angela Chisum Blackburn | Nurse Practitioner | 5149 N 9th Ave, Suite G-27, Pensacola, FL 32504-8756 | 2006-10-31 |
| 1780646406 | Angela Holt Blackburn | Nurse Practitioner | 208 Old Mocksville Rd, Statesville, NC 28625-1953 | 2006-04-06 |
| Street Address |
31208 DAY LILY DR |
| City | BROWNSTOWN |
| State | MI |
| Zip Code | 48173-8768 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508416355 | Stephanie Lauren Marl | Nurse Practitioner | 29800 Adams Dr, Gibraltar, MI 48173 | 2019-09-13 |
| 1568770493 | Janis Lee Gilliam | Massage Therapist | 32121 Old Fort, Rockwood, MI 48173 | 2010-09-14 |
| 1982807913 | Lisa G Heidemann | Registered Nurse | 1450 S Lapeer, Oxford, MI 48173 | 2007-06-07 |
| 1215066279 | Craig Arlen Birch | Dentist | 21969 Huron River Drive, Rockwood, MI 48173 | 2007-03-05 |
| 1992850226 | Chad Jason Eschliman | Radiologic Technologist | 33285 Spoonbill Ave, Brownstown, MI 48173 | 2007-01-25 |
| 1871983072 | Karen Cupp | Psychologist | 21825 Woodruff Rd, Apt G3, Rockwood, MI 48173-1062 | 2015-01-27 |
| 1093016438 | Susans Total Care Drug Store LLC | Durable Medical Equipment & Medical Supplies | 22432 Huron River Dr, Rockwood, MI 48173-1100 | 2010-11-16 |
| 1407895865 | City of Rockwood | Ambulance | 32409 Fort Rd, Rockwood, MI 48173-1111 | 2006-06-04 |
| 1083934988 | Robin Elizabeth Burnstein | Pharmacist | 32905 Fort Rd, Rockwood, MI 48173-1112 | 2010-06-03 |
| 1659394211 | Perry Drug Stores Inc and Subsidiaries | Durable Medical Equipment & Medical Supplies | 32905 Fort Street, Rockwood, MI 48173-1112 | 2006-07-25 |
| Find all providers in zip 48173 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346271236 | Donna Kiser | Nurse Practitioner | 4131 Oregon Pike, Brownstown, PA 17508 | 2006-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154599 | Kelly Phuong Doan | Nurse Practitioner | 27327 23 Mile Rd, Chesterfield, MI 48051-2045 | 2020-11-04 |
| 1275133217 | Maureen Mae Lewis | Nurse Practitioner | 2782 N Coleman Rd, Coleman, MI 48618-9721 | 2020-10-29 |
| 1073113460 | Taylor L Pichette | Nurse Practitioner | 758 Lucille Dr, Wolverine Lake, MI 48390-2327 | 2020-10-27 |
| 1295333938 | Amanda Covell | Nurse Practitioner | 624 Cherry St Se Apt 5, Grand Rapids, MI 49503-4778 | 2020-10-14 |
| 1689271314 | Nicole Conklin | Nurse Practitioner | 524 Doyle Rd, Laingsburg, MI 48848-9611 | 2020-10-06 |
| 1447857677 | Shelby Lynn Waibel | Nurse Practitioner | 560 W Mitchell St Ste 210, Petoskey, MI 49770-2276 | 2020-10-01 |
| 1497361638 | Amira Aljamal | Nurse Practitioner | 4601 Shenandoah Ave, Allen Park, MI 48101-3131 | 2020-09-22 |
| 1659987014 | Sean Thomas Kane | Nurse Practitioner | 13734 Parallel Ave, Alpena, MI 49707-7987 | 2020-09-21 |
| 1235743592 | Mojica, LLC | Nurse Practitioner | 4163 W Pointe Dr, Waterford, MI 48329-4648 | 2020-09-03 |
| 1942812094 | Meagan James | Nurse Practitioner | 407 E Huron River Dr, Belleville, MI 48111-2763 | 2020-08-20 |
| Find all providers with the same taxonomy | ||||
| City | BROWNSTOWN |
| Zip Code | 48173 |
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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.