National Provider Identifier Database

BETTIE BLACKMON, FNP-C – NPI #1356344949
Family


Contact Information

BETTIE BLACKMON, FNP-C
11990 JACKSON ST
CLINTON, LA70722-3210
Phone: 225-683-5292
Fax: 225-683-3411
Website:
Specialty Taxonomy Code
* Family 363LF0000X

* Indicates primary specialty

NPI Profile & details for BETTIE BLACKMON

NPI Number 1356344949
Credentials FNP-C (Family Nurse Practitioner, Certified)
Entity Individual
Enumeration date 05/27/2005
Last updated 03/07/2023 - About 3 years ago
Sole proprietor1 No
Identifiers
  • LA License #: AP03903
  • LA Medicaid: 1114367
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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