Provider Demographics
NPI:1063191070
Name:BLACKWELL, ELENA JOSEPHINA (RN)
Entity type:Individual
Prefix:
First Name:ELENA
Middle Name:JOSEPHINA
Last Name:BLACKWELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ELENA
Other - Middle Name:JOSEPHINA
Other - Last Name:BARNES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1430 SW WOODHULL ST UNIT 4702
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66604-2524
Mailing Address - Country:US
Mailing Address - Phone:785-217-8231
Mailing Address - Fax:
Practice Address - Street 1:2000 NW US HIGHWAY 24
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66618-1445
Practice Address - Country:US
Practice Address - Phone:785-295-7111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS155971163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse