Individual provider · Type 1 NPI
Stacey Melissa Blackman, APN
Primary Care Nurse Practitioner · East Orange, NJ
NPI number
1366760373
Active
Practice location
9 Wayne Ave
East Orange, NJ 07018
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Legal Medicine | 173000000X | 26NJ00286100 (NJ) |
| Family Nurse Practitioner | 363LF0000X | 26NJ00286100 (NJ) |
| Primary Care Nurse Practitioner Primary | 363LP2300X | 26NJ00286100 (NJ) |
Primary Care Nurse Practitioner: Definition to come...
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About NPI 1366760373
Stacey Melissa Blackman, APN's National Provider Identifier is 1366760373, issued on May 14, 2010. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in East Orange, NJ. The record was last updated on Jul 25, 2018.