NPI 1992424295 · live from the CMS NPI Registry
Caroline Blackburn
Physician Assistant in Charleston, WV. National Provider Identifier 1992424295, active.
NPI record
| NPI | 1992424295 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 3200 Maccorkle Ave Se, Charleston, WV 25304 |
| Practice phone | 304-388-5432 |
| Mailing address | 580 Pond Creek Rd, Huddy, KY 41535 |
| Enumerated | August 22, 2022 |
| Last updated | August 22, 2022 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant primary | 363A00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.