Kelly Costello Blackmon is a Waycross, Georgia based nurse practitioner with 11 years of experience in Acute Care. She completed her graduation in 2014. She accepts the Medicare-approved amount. Patients will not be billed for any more than the Medicare deductible and coinsurance. Active license number of Kelly Costello Blackmon is RN124057 in Georgia. Her current practice location is 1706 Alice St, Waycross. Patients can reach her at 912-285-1140 or can fax her at 912-285-1125. Kelly Costello Blackmon is APRN with specialization in Acute Care and her NPI number (Unique professional ID assigned by NPPES) is 1992110688. Kelly Costello Blackmon is a licensed independent practitioner and may autonomously provide care. She provides advanced nursing care across the continuum of health care services to meet the specialized physiologic and psychological needs of patients with acute, critical, and/or complex chronic health conditions. This care is continuous and comprehensive and may be provided in any setting where the patient may be found.
Complete Profile:
Kelly Costello Blackmon speciality, credentials, practice address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointment.
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
PAC ID:
3072830058
Enrollment ID:
I20150401001028
NPI Number:
1992110688
NPI Enumeration Date:
22 Jun, 2014
NPI Last Update On:
03 Jan, 2025
Medical Licenses:
NPs can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Kelly Costello Blackmon are as mentioned below.
License Number
Specialization
State
Status
RN124057
Georgia
Primary
RN124057
Acute Care
Georgia
Secondary
Hospital Affiliation:
NPs can be affiliated to many hospitals whom they worked with in the past or are presently working with. One NP can be affiliated to four to five hospitals at a time.
Hospital Name (CCN)
State
Hospital Type
(110122)
Valdosta, GA
Acute Care Hospital
Group Practice:
Group practices are practice of medicine by a group of NPs who share their premises and other resources. Following list states all the group name
with which Kelly Costello Blackmon is associated with along with the number of members in that group.
Organization Name (Group PAC ID)
Members
Hospital Authority Of Valdosta And Lowndes County Georgia (1355334509)
57
Other Medical Identifiers:
Other legacy medical identifiers associated with Kelly Costello Blackmon such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
003154267A
Medicaid
Georgia
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
Kelly Costello Blackmon Po Box 749495, Atlanta, Georgia
Zip:
30374-9495
Phone Number:
855-963-2100
Fax Number:
239-236-2775
Patients can reach Kelly Costello Blackmon at 1706 Alice St, Waycross, Georgia or can call to book an appointment on 912-285-1140.
Comments/ Reviews:
Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 13 January, 2025.