BLACKHAWK MEDICAL PLLC NPI 1710807664

NPI Information

  • NPI: 1710807664
  • Provider Name: BLACKHAWK MEDICAL, PLLC
  • Classification: Nurse Practitioner - 363LA2200X
  • Specialization: Adult Health
  • Entity Type: Organization
  • Address: 115 AULENBROCK DR # 100-B
    CANTON, MS
    ZIP 39046
  • Phone: (601) 624-1082

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NPI Details

BLACKHAWK MEDICAL, PLLC is an adult health nurse practitioner in Canton, MS. BLACKHAWK MEDICAL, PLLC NPI is 1710807664. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

115 AULENBROCK DR # 100-B
CANTON, MS
ZIP 39046-061
Phone: (601) 624-1082

The provider's authorized official is Virginia Lea Powell .
The authorized official title is Owner, Nurse Practitioner and has the following contact phone number (601) 624-1082.

The enumeration date for this NPI number is 7/20/2026 and was last updated on 7/20/2026.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363L00000XNurse PractitionerNo
2363LA2200XNurse PractitionerAdult HealthYes
3363LG0600XNurse PractitionerGerontologyNo
4363LP2300XNurse PractitionerPrimary CareNo

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: 11/21/2025

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