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

Katrina Marie Blackard, NP

Individual provider Primary Care Nurse Practitioner · NPI 1467051029

Katrina Marie Blackard, NP is a Nurse Practitioner in Southaven, Mississippi. Qualified in 2020, 6 years ago. Practices with Memphis Lung Physicians Foundation, Inc, a 57-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Mississippi and Tennessee.

Years since qualifying
6
Licensed in
MS, TN
In the registry since
2020
Specialties on file
2
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

401 Southcrest Cir Ste 212
Southaven, MS 38671-6721
Phone: (662) 349-0488
Fax: (662) 349-5974
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2120 Exeter Rd Ste 250, Germantown, TN 38138-3931 — (901) 767-5864

Specialties & licences

Primary Care Nurse Practitioner (primary) Taxonomy 363LP2300X · Licence 904313 (MS)
Primary Care Nurse Practitioner Taxonomy 363LP2300X · Licence 28617 (TN)

Record details

NPI number1467051029
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorNo
NPI enumeratedOctober 23, 2020
Last updated in NPPESJuly 13, 2022
Certification dateJuly 13, 2022

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Memphis Lung Physicians Foundation, Inc. — 57 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Southaven