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Nanci Jacqulyn Sullivan-blackert, RN,MSN,CDE,NP-C
Family Nurse Practitioner in Raleigh, North Carolina
NPI 1568718336

Nanci Jacqulyn Sullivan-blackert is a Family Nurse Practitioner based in Raleigh, NC and is specialized in Family. Nanci Jacqulyn Sullivan-blackert practices in Raleigh, NC and has the professional credentials of RN,MSN,CDE,NP-C. The NPI Number for Nanci Jacqulyn Sullivan-blackert is 1568718336 and holds a License No. F0512372 (North Carolina).

The current practice location address for Nanci Jacqulyn Sullivan-blackert is 3604 Bush St, Raleigh, NC and can be reached out via phone at 919-876-7807 and via fax at 919-459-8402.

Location: 3604 Bush St, Raleigh, NC, 27609-7511
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Provider Profile Details
NPI Number
1568718336
Provider Name
Nanci Jacqulyn Sullivan-blackert
Credential
RN,MSN,CDE,NP-C
Provider Entity Type
Individual
Gender
Female
Address
3604 Bush St, Raleigh, NC, 27609-7511
Phone Number
919-876-7807
Fax Number
919-459-8402
Provider Enumeration Date
07/31/2012
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
FH4001480 01 NC FIRST CAROLINA CARE, INC
FH4001480 01 NC FIRST MEDICARE DIRECT
1568718336 05 NC
1568718336 01 HNFS/TRICARE
institution
Provider Business Practice Location Address Details
Address
3604 Bush St
City
State
Zip
27609-7511
Phone Number
919-876-7807
Fax Number
919-459-8402
person
Provider Business Mailing Address Details
Address
3604 Bush St
City
State
Zip
27609-7511
Phone Number
919-876-7807
Fax Number
919-459-8402
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
F0512372 (North Carolina)
Definition
Definition to come...
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