SALLY BLACKBURN


Address: 2195 Euclid Ave, Suite 6, Bristol, VA 24201-3655
Phone: 2766695179

SALLY BLACKBURN (NPI# 1700857216) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1700857216
Entity Type Individual
Full Name SALLY BLACKBURN
Other Name SALLY PENNINGS
Credential NP
Practice Address 2195 Euclid Ave
Suite 6
Bristol
VA 24201-3655
Mailing Address Po Box 729
Saltville
VA 24370-0729
Practice Telephone 2766695179
Practice Fax Number 2764668870
Mailing Telephone 2764964492
Mailing Fax Number 2764964839
Enumeration Date 2006-02-01
Last Update Date 2016-10-05
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
0024164957 VA Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
TN Q006676 05

Other Providers SALLY BLACKBURN

NPI Name Taxonomy Address Enumeration
1972918332 Sally Blackburn Counselor 7955 Big Bend Blvd, Saint Louis, MO 63119-2703 2014-06-24

Office Location

Street Address 2195 EUCLID AVE
SUITE 6
City BRISTOL
State VA
Zip Code 24201-3655

Providers in the same location

NPI Name Taxonomy Address Enumeration
1588635114 Roy Robert Andrews Family Medicine 2195 Euclid Ave, Bristol, VA 24201-3655 2006-01-31
1629612759 Kimberly J Patrick Social Worker 2195 Euclid Ave, Bristol, VA 24201 2019-11-01
1295852952 Joan E Mullin Nurse Practitioner 2195 Euclid Ave, Suite 6, Bristol, VA 24201-3655 2007-03-26
1922191832 Donna Elaine Boggs Social Worker 2195 Euclid Ave, Suite 6, Bristol, VA 24201-3655 2006-10-02
1184642100 Gayle Catherine Bates Pediatrics 2195 Euclid Ave, Suite 6, Bristol, VA 24201-3655 2006-07-17
1467416842 John Farthing Internal Medicine 2195 Euclid Ave, Bristol, VA 24201-3655 2006-04-13

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1699234716 Vanessa Ruiz Sutherland Speech-Language Pathologist Stonewall Jackson Elementary School, 2045 Euclid Ave, Bristol, VA 24201 2019-03-18
1003394693 Cplace Bristol Snf, LLC Clinic/Center 109 Village Circle, Bristol, VA 24201 2018-08-06
1871001420 Karen Lavonne Ford Case Manager/Care Coordinator 727 Portsmouth Avenue, Bristol, VA 24201 2018-01-17
1558872176 City of Bristol Va Ambulance 211 Lee St, Bristol, VA 24201 2017-10-23
1639396989 Barry Robert Matheson Dentist 817 Gate City Highway, Bristol, VA 24201 2007-04-19
1942338082 Joann Wolfe Vaughn Nurse Practitioner 103 North Street, Ridgeview Pavilion, Bristol, VA 24201 2007-03-01
1003982968 American Medical Devices, Inc. Durable Medical Equipment & Medical Supplies 1788 Island Rd, Bristol, VA 24201 2006-11-24
1134224827 Theresa D Morris Licensed Practical Nurse 510 Cumberland St, Executive Plaza 4th Floor, Bristol, VA 24201 2006-09-14
1083718605 Tomhave Olson Dental Associates Dentist 510 Cumberland St., Executive Plaza, 4th Floor, Bristol, VA 24201 2006-09-12
1972606408 Terry H Gillenwater Chiropractor 2110 Euclid Ave, Bristol, VA 24201 2006-09-07
Find all providers in zip 24201

Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1154921120 Melissa Ann Mcnutt Nurse Practitioner 941 Windsor Ave, Bristol, TN 37620-2155 2020-10-29
1124633581 Kristen L Viars Nurse Practitioner 501 Garden Ln, Bristol, VA 24201-1512 2020-09-12
1780295071 Leslie Berryman Nurse Practitioner 901 Hill St, Bristol, TN 37620-2141 2020-08-11
1972134021 Shonna Morenings Nurse Practitioner 200 Richmond Heights Rd, Bristol, TN 37620-6612 2020-01-28
1891347936 Brittney O'hara Nurse Practitioner 350 Steeles Rd Ste 2, Bristol, TN 37620-9532 2019-07-09
1518524628 Constance K Siekierski Nurse Practitioner 17 Platt St, Bristol, RI 02809-4317 2019-05-23
1477014827 Mary Beth Foran Nurse Practitioner 1135 Columbia Rd, Bristol, TN 37620-4421 2019-03-28
1932663580 Dana Lynn Mcdonnell Nurse Practitioner 415 Hart St, Bristol, CT 06010-2393 2019-01-29
1215405352 Linda Carol Holmes Nurse Practitioner 1 Monarch Dr, Bristol, VA 24201-3138 2018-11-07
1922521608 Connie A Bronson Nurse Practitioner 55020 Colonial Ridge Dr, Bristol, IN 46507-8901 2017-07-25
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Competitor

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City BRISTOL
Zip Code 24201

Improve Information

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Dataset Information

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.

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