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NPI Code Detail

MEDICARE: MS. SARAH ELIZABETH BLACKBURN APRN

MEDICARE:  MS. SARAH ELIZABETH BLACKBURN  APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner3008465KY

General Provider Information

NPI Number : 1205268190
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SARAH ELIZABETH BLACKBURN APRN
Provider Business Mailing Address
First Line : 2620 ELM HILL PIKE
Second Line :
City : NASHVILLE
State : TN
Zip : 37214-3108
Country : US
Telephone Number : 615-425-4200
Fax Number : 615-425-4268
Provider Business Practice Location Address
First Line : 130 PAVILION PKWY
Second Line :
City : NEWPORT
State : KY
Zip : 41071-2998
Country : US
Telephone Number : 859-652-7203
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2013
Last Update Date : 03/13/2026

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