Provider Demographics
NPI:1518181619
Name:NEBLETT-BLACKMON, JOVANNI (MD)
Entity Type:Individual
Prefix:
First Name:JOVANNI
Middle Name:
Last Name:NEBLETT-BLACKMON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1575 HIGHLANDS DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LITITZ
Mailing Address - State:PA
Mailing Address - Zip Code:17543-7507
Mailing Address - Country:US
Mailing Address - Phone:888-393-1338
Mailing Address - Fax:717-627-1817
Practice Address - Street 1:1575 HIGHLANDS DR
Practice Address - Street 2:SUITE 101
Practice Address - City:LITITZ
Practice Address - State:PA
Practice Address - Zip Code:17543-7507
Practice Address - Country:US
Practice Address - Phone:888-393-1338
Practice Address - Fax:717-627-1817
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD435904207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology