Siara S Blackburn
Physician Assistant in Wilmington, North Carolina
1063228468- Practice location
- 3787 Shipyard Blvd, Wilmington, NC 28403-6148
- Phone
- 910-332-3800
- Fax
- 910-251-0421
- Last updated
- January 18, 2026
Siara Southerland Blackburn is a Physician Assistant based in Wilmington, NC. Siara Southerland Blackburn practices in Wilmington, NC. The NPI Number for Siara Southerland Blackburn is 1063228468 and holds a License No. 0010-15739 (NC). The current practice location address for Siara Southerland Blackburn is 3787 Shipyard Blvd, Wilmington, NC 28403-6148 and can be reached out via phone at 910-332-3800 and via fax at 910-251-0421.
Provider Profile Details
- NPI Number
- 1063228468
- Provider Name
- Siara Southerland Blackburn
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 3787 Shipyard Blvd, Wilmington, NC 28403-6148
- Phone Number
- 910-332-3800
- Fax Number
- 910-251-0421
- Primary Taxonomy
- Physician Assistant · 363A00000X
- Sole Proprietor
- No
- Other Names
- Siara Nicole Southerland (Former Name)
- Provider Enumeration Date
- December 10, 2024
- Last Update Date
- January 18, 2026
- Certification Date
- January 18, 2026
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 3787 Shipyard Blvd
Wilmington, NC 28403-6148 - City
- Wilmington
- State
- North Carolina
- Zip
- 28403-6148
- Phone Number
- 910-332-3800
- Fax Number
- 910-251-0421
Provider Business Mailing Address Details
- Address
- Po Box 5105
Belfast, ME 04915-5100 - City
- Belfast
- State
- ME
- Zip
- 04915-5100
- Phone Number
- 910-332-3800
- Fax Number
- 910-251-0421
License Information
- Taxonomy (1)
- Student in an Organized Health Care Education/Training Program · 390200000X
- License Number (2)
- 0010-15739
- License State (2)
- NC
- Taxonomy (2)
- Physician Assistant · 363A00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Physician Assistants near Wilmington, NC
View all Physician Assistants in Wilmington →Frequently Asked Questions
What is the NPI number of Siara S Blackburn?
The NPI number of Siara S Blackburn is 1063228468. It was assigned on December 10, 2024 and is currently active in the NPPES registry.
What is the specialty of Siara S Blackburn?
Siara S Blackburn is registered under the primary taxonomy Physician Assistant (code 363A00000X), licensed in NC under license number 0010-15739.
Where does Siara S Blackburn practice?
The practice location is 3787 Shipyard Blvd, Wilmington, NC 28403-6148. The office can be reached at 910-332-3800 (phone) or 910-251-0421 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1063228468 directly on the NPPES registry website.