Provider Demographics
NPI:1003000282
Name:BLAKEMORE, ROSIE K (FNP)
Entity Type:Individual
Prefix:
First Name:ROSIE
Middle Name:K
Last Name:BLAKEMORE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:TENNESSEE PRISON FOR WOMEN
Mailing Address - Street 2:3881 STEWARTS LANE
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37243-0001
Mailing Address - Country:US
Mailing Address - Phone:615-741-1255
Mailing Address - Fax:615-726-2181
Practice Address - Street 1:TENNESSEE PRISON FOR WOMEN
Practice Address - Street 2:3881 STEWARTS LANE
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37243-0001
Practice Address - Country:US
Practice Address - Phone:615-741-1255
Practice Address - Fax:615-726-2181
Is Sole Proprietor?:No
Enumeration Date:2007-08-30
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000005086363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily