Provider Demographics
NPI:1821488446
Name:BLALOCK, ERIN (APRN - PMHNP)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:BLALOCK
Suffix:
Gender:F
Credentials:APRN - PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 BOSTON RD
Mailing Address - Street 2:
Mailing Address - City:CALHOUN
Mailing Address - State:GA
Mailing Address - Zip Code:30701-2207
Mailing Address - Country:US
Mailing Address - Phone:678-982-2305
Mailing Address - Fax:
Practice Address - Street 1:2945 MILLER FERRY RD SW
Practice Address - Street 2:
Practice Address - City:CALHOUN
Practice Address - State:GA
Practice Address - Zip Code:30701-7538
Practice Address - Country:US
Practice Address - Phone:706-602-9234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-03
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN203918163W00000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse