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NPI Code Detail

MEDICARE: MS. RONNETTA BLACKWELL RN

MEDICARE: MS. RONNETTA BLACKWELL RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WP2201XAmbulatory Care Registered NurseRN.531792OH

General Provider Information

NPI Number : 1124784061
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. RONNETTA BLACKWELL RN
Provider Business Mailing Address
First Line : 2665 MELLOWBROOK ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43232-4707
Country : US
Telephone Number : 614-702-6115
Fax Number :
Provider Business Practice Location Address
First Line : 420 N JAMES RD
Second Line :
City : COLUMBUS
State : OH
Zip : 43219-1834
Country : US
Telephone Number : 614-257-5200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2021
Last Update Date : 03/10/2026

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