IndividualActive
Amanda Blackmon
NPI 1083995518 · Certified Registered Nurse Anesthetist · Tupelo, MS
Provider details
- NPI number
- 1083995518
- Entity type
- Individual
- Primary specialty
- Certified Registered Nurse AnesthetistPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Female
- Sole proprietor
- No
- License
- R898893 (MS)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
830 S Gloster St
Tupelo, MS 38801-4934
Phone: (662) 377-4394
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 3294
Tupelo, MS 38803-3294
Registry dates
- Enumerated
- 2011-08-29
- Last updated
- 2015-01-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.