Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jaqueline Dare Blackmon, PMHNP

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1689370769

Jaqueline Dare Blackmon, PMHNP is a Nurse Practitioner in Ruskin, Florida. Qualified in 2022, 4 years ago. Practices with Whitechapel Behavioral Services, a 2-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
4
Licensed in
FL
In the registry since
2023
What do these letters mean?
PMHNP — Psychiatric-Mental Health Nurse Practitioner
A nurse practitioner specialising in mental health, able to prescribe psychiatric medication.

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Practice location Address checks out

1610 Climbing Dayflower Dr
Ruskin, FL 33570-4949
Phone: (910) 584-0980
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 11024186 (FL)

Record details

NPI number1689370769
Entity typeIndividual (Type 1)
GenderFemale
Credentials PMHNP
Sole proprietorNo
NPI enumeratedFebruary 1, 2023
Last updated in NPPESFebruary 1, 2023
Certification dateJanuary 12, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Whitechapel Behavioral Services — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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