Blackman, Angela Payne

Blackman, Angela Payne is an individual health care provider with primary practice located at 1350 Hickory St , Melbourne FL 32901-3224. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Acute Care. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Blackman, Angela Payne can be contacted via phone (321) 434-1771.

Contact Information

Primary practice address
1350 Hickory St Melbourne FL 32901-3224
Phone: (321) 434-1771
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X L138707 Iowa
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 0024169643 Virginia
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 0024169643 Virginia
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X ARNP9358792 Florida

Profile Details

NPI number 1396029187
LBN Legal business name Blackman, Angela Payne
Credentials ACNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 28th, 2011
Last updated Apr 1st, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396029187 NPPES
Florida MEDICAID 100559200
Florida Other NJ493
Florida Other IZ355Z

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