person
Kelly Costello Blackmon, APRN
Acute Care Nurse Practitioner in Valdosta, Georgia
NPI 1992110688

Kelly Costello Blackmon is an Acute Care Nurse Practitioner based in Valdosta, GA and is specialized in Acute Care. Kelly Costello Blackmon practices in Valdosta, GA and has the professional credentials of APRN. The NPI Number for Kelly Costello Blackmon is 1992110688 and holds a License No. RN124057 (Georgia).

The current practice location address for Kelly Costello Blackmon is 2409 N. Patterson Street, Valdosta, GA and can be reached out via phone at 229-259-4369 and via fax at 229-433-6513. You can also correspond with Kelly Costello Blackmon through the mailing address at PO BOX 0070, VALDOSTA, GA - 31603-0070 (mailing address contact number: 229-259-4369).

Location: 2409 N. Patterson Street, Valdosta, GA, 31603-0070
person
Provider Profile Details
NPI Number
1992110688
Provider Name
Kelly Costello Blackmon
Credential
APRN
Provider Entity Type
Individual
Gender
Female
Address
2409 N. Patterson Street, Valdosta, GA, 31603-0070
Phone Number
229-259-4369
Fax Number
229-433-6513
Provider Enumeration Date
06/22/2014
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
003154267A 05 GA
institution
Provider Business Practice Location Address Details
Address
2409 N. Patterson Street
City
State
Zip
31602-2512
Phone Number
229-259-4369
Fax Number
229-433-6513
person
Provider Business Mailing Address Details
Address
2409 N. Patterson Street
City
State
Zip
31602-2512
Phone Number
229-259-4369
Fax Number
229-433-6513
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Acute Care
Taxonomy
License No.
RN124057 (Georgia)
Definition
Definition to come...
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