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General NPI Number Information
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NPI Number | 1932711058
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Entity Type | Individual
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Provider Name | BLAKELEE BROCK BARNETT APRN
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Gender | Female
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Dates
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Enumeration Date | 08/19/2020
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Last Update Date | 08/19/2020
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Provider Practice Location Address
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Address Line | 2004 CUMBERLAND AVE STE 100
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City | MIDDLESBORO
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State | KY
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Zip | 40965-1385
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Country | US
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Telephone | 606-248-3015
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Fax |
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Provider Business Mailing Address
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Address Line | 1404 W CHESTER AVE
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City | MIDDLESBORO
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State | KY
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Zip | 40965-2376
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Country | US
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Telephone | 606-499-0205
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3012948
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number |
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License Number State |
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