Provider Demographics
NPI:1316287030
Name:BLACKERBY, JENNIFER LYNNE (CRNP)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LYNNE
Last Name:BLACKERBY
Suffix:
Gender:F
Credentials:CRNP
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Mailing Address - Street 1:503 S 5TH ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35901-5103
Mailing Address - Country:US
Mailing Address - Phone:256-546-6200
Mailing Address - Fax:256-546-6250
Practice Address - Street 1:213 S 5TH ST
Practice Address - Street 2:SUITE 110
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35901-4217
Practice Address - Country:US
Practice Address - Phone:256-546-1190
Practice Address - Fax:256-546-1193
Is Sole Proprietor?:No
Enumeration Date:2013-02-15
Last Update Date:2016-08-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL1-097717363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily