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KATRINA MARIE BLACKARD NP NPI 1467051029


NPI Information

NPI: 1467051029
Provider Name: KATRINA MARIE BLACKARD, NP
Classification: Nurse Practitioner - 363LP2300X
Entity Type: Individual

Specialization: Primary Care

PECOS Registration: Yes

Address:
401 SOUTHCREST CIR STE 212
SOUTHAVEN, MS
ZIP 38671
Phone: (662) 349-0488
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Katrina Marie Blackard, NP is a primary care nurse practitioner in Southaven, MS with 4 years of experience. Katrina Marie Blackard, NP NPI is 1467051029. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

401 SOUTHCREST CIR STE 212
SOUTHAVEN, MS
ZIP 38671-721
Phone: (662) 349-0488
Fax: (662) 349-5974

The NPI 1467051029 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/23/2020 and was last updated on 7/13/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363LP2300XNurse PractitionerPrimary Care904313MISSISSIPPIYes
2363LP2300XNurse PractitionerPrimary Care28617TENNESSEENo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.