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General NPI Number Information
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NPI Number | 1225618713
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Entity Type | Organization
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Legal Business Name | BLACKWELL NURSING SERVICES LLC
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Dates
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Enumeration Date | 04/09/2021
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Last Update Date | 04/09/2021
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Provider Practice Location Address
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Address Line | 19 CLAIRMONT CIRCLE
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City | LAUREL
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State | MS
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Zip | 39440
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Country | US
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Telephone | 601-342-2021
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Fax | 601-342-2714
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Provider Business Mailing Address
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Address Line | PO BOX 2276
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City | LAUREL
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State | MS
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Zip | 39442
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KEVIN SMITH
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Credential |
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Telephone | 601-342-2021
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number |
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License Number State |
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