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General NPI Number Information
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NPI Number | 1295692499
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Entity Type | Individual
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Provider Name | AMY BLACKBURN
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Gender | Female
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Dates
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Enumeration Date | 01/08/2026
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Last Update Date | 01/08/2026
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Provider Practice Location Address
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Address Line | 1224 E LOWELL ST
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City | TUCSON
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State | AZ
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Zip | 85721-0095
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Country | US
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Telephone | 520-621-8057
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Fax |
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Provider Business Mailing Address
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Address Line | 7234 E PLACITA RANCHO LA CHOLLA
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City | TUCSON
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State | AZ
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Zip | 85715-3252
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Country | US
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Telephone | 520-621-8057
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC1400X
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Taxonomy Name | College Health Registered Nurse
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License Number | RN085043
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License Number State | AZ
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