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

Miss. Anita Jane Blackwell, RNCPNP

Individual provider Pediatric Nurse Practitioner · NPI 1790808681

Miss. Anita Jane Blackwell, RNCPNP is a Pediatric Nurse Practitioner in Saint Louis, Missouri. Licensed in Missouri and Texas. Registered with an NPI since 2007.

Licensed in
MO, TX
In the registry since
2007
Specialties on file
2

Practice location Address checks out

4055 Lindell Blvd
Saint Louis, MO 63108-3201
Phone: (314) 535-7701
Fax: (314) 535-0207
Show map & directions

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

Specialties & licences

Pediatric Nurse Practitioner (primary) Taxonomy 363LP0200X · Licence 061036 (MO)
Pediatric Nurse Practitioner Taxonomy 363LP0200X · Licence AP133887 (TX)

Record details

NPI number1790808681
Entity typeIndividual (Type 1)
GenderFemale
Credentials RNCPNP
Sole proprietorNo
NPI enumeratedApril 7, 2007
Last updated in NPPESSeptember 22, 2022
Certification dateSeptember 22, 2022

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