Offutt-Blackaby, Jo Susan

Offutt-Blackaby, Jo Susan is an individual health care provider with primary practice located at 2006 Maggie Ct , Greenbrier TN 37073-0500. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Offutt-Blackaby, Jo Susan can be contacted via phone (615) 620-0998.

Contact Information

Primary practice address
2006 Maggie Ct Greenbrier TN 37073-0500
Phone: (615) 620-0998
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 25460 South Carolina
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 364SP0808X 19574 Tennessee
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 19574 Tennessee

Profile Details

NPI number 1689063760
LBN Legal business name Offutt-Blackaby, Jo Susan
Credentials MSN, PMHNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 13th, 2015
Last updated Jan 4th, 2024 - about 2 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 1689063760 NPPES
South Carolina Other 3335 MEDICARE
South Carolina MEDICAID 421504 MEDICARE

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