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General NPI Number Information
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NPI Number | 1790629368
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Entity Type | Individual
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Provider Name | TASMIYAH BLACKWELL
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Gender | Female
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Dates
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Enumeration Date | 04/15/2026
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Last Update Date | 04/15/2026
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Provider Practice Location Address
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Address Line | 230 MITCHELL ST STE B
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City | MILLSBORO
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State | DE
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Zip | 19966-9402
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Country | US
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Telephone | 267-261-6955
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Fax |
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Provider Business Mailing Address
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Address Line | 1307 LIGHTHORSE LN
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City | CLAYMONT
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State | DE
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Zip | 19703-3354
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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 |
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | L8-0011107
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License Number State | DE
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