Individual provider · Type 1 NPI
Bonita Jody Blackman, APRN, PMHNP
Psychiatric/Mental Health Nurse Practitioner · Bear, DE
NPI number
1629956479
Active
Practice location
1148 Pulaski Hwy Ste 167
Bear, DE 19701-1305
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | L8-0010711 (DE) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1629956479
Bonita Jody Blackman, APRN, PMHNP's National Provider Identifier is 1629956479, issued on Aug 21, 2025. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Bear, DE. The record was last updated on Aug 22, 2025.