Basic Information
| Provider Information | |||||||||
| NPI: | 1003000282 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BLAKEMORE | ||||||||
| FirstName: | ROSIE | ||||||||
| MiddleName: | K | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | TENNESSEE PRISON FOR WOMEN | ||||||||
| Address2: | 3881 STEWARTS LANE | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372430001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6157411255 | ||||||||
| FaxNumber: | 6157262181 | ||||||||
| Practice Location | |||||||||
| Address1: | TENNESSEE PRISON FOR WOMEN | ||||||||
| Address2: | 3881 STEWARTS LANE | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372430001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6157411255 | ||||||||
| FaxNumber: | 6157262181 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2007 | ||||||||
| LastUpdateDate: | 08/30/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | APN0000005086 | TN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.