Individual provider · Type 1 NPI
Jaqueline Dare Blackmon, PMHNP
Psychiatric/Mental Health Nurse Practitioner · Ruskin, FL
NPI number
1689370769
Active
Practice location
1610 Climbing Dayflower Dr
Ruskin, FL 33570-4949
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 11024186 (FL) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1689370769
Jaqueline Dare Blackmon, PMHNP's National Provider Identifier is 1689370769, issued on Feb 1, 2023. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Ruskin, FL. The record was last updated on Feb 1, 2023.