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

Wolleta Blackwood

Individual provider Registered Nurse · NPI 1356196752

Wolleta Blackwood is a Registered Nurse in Elmont, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2024

Practice location Address checks out

1944 Jackson Ave
Elmont, NY 11003-4200
Phone: (516) 424-0169
Show map & directions

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

Specialties & licences

Registered Nurse (primary) Taxonomy 163W00000X · Licence 610154 (NY)

Record details

NPI number1356196752
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedApril 19, 2024
Last updated in NPPESApril 21, 2024
Certification dateApril 21, 2024
Mailing address1944 Jackson Ave, Elmont, NY 11003-4200

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