Individual provider · Type 1 NPI
Charla Geri Blackwell
Child & Adolescent Psychiatric/Mental Health Registered Nurse · Brandon, MS
NPI number
1508711904
Active
Practice location
613 Marquette Rd
Brandon, MS 39042-3038
Mailing address
128 Willow Crest Cir
Brandon, MS 39047-7064
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Child & Adolescent Psychiatric/Mental Health Registered Nurse Primary | 163WP0807X | 883208 (MS) |
Child & Adolescent Psychiatric/Mental Health Registered Nurse: Definition to come...
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About NPI 1508711904
Charla Geri Blackwell's National Provider Identifier is 1508711904, issued on Mar 2, 2026. The primary taxonomy on file is Child & Adolescent Psychiatric/Mental Health Registered Nurse (163WP0807X), and the practice location is in Brandon, MS. The record was last updated on Mar 2, 2026.