Most Relevant Information
Provider Data
| NPI Number: | 1003573429 |
| Provider Name: | JANIS S BLACKWELL RN, CCM |
| Entity Type: | Individual |
| Taxonomy Code: | 163WC0400X |
| Specialty: | Registered Nurse |
| License Number: | R088001 |
Most Important Dates
| Enumeration Date: | 11/19/2021 |
| Last Updated: | 11/19/2021 |
Provider Practice Location
29677 LYONS DR
EASTON
MD
216014743
Practice Location Phone/Fax
| Phone: | 4437860597 |
| Fax: |
Provider Mailing Location
29677 LYONS DR
EASTON
MD
216014743
Provider Mailing Phone/Fax
| Phone: | 4437860597 |
| Fax: |