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General NPI Number Information
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NPI Number | 1679542575
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Entity Type | Individual
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Provider Name | JAMIE MORGAN BLACKWELDER ENP
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Gender | Female
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Dates
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Enumeration Date | 03/15/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | J R JONES MEDICAL CENTER 402 WEST KING ST
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City | KING
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State | NC
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Zip | 27021
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Country | US
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Telephone | 336-983-9617
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Fax | 336-983-9791
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Provider Business Mailing Address
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Address Line | 1140 JAMIE LN
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City | GERMANTON
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State | NC
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Zip | 27019-9157
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Country | US
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Telephone | 336-994-4005
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 700003
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License Number State | NC
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