# MS. MARY ZOE BLACKBURN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1699930628
- **Gender:** F
- **Credential:** RN, CNS-MS-BC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | AP111190 | TX | Yes |
| 364S00000X | Clinical Nurse Specialist | AP111190 | TX | — |
| 364SM0705X | Medical-Surgical Clinical Nurse Specialist | AP111190 | TX | — |

## Other

- **Enumeration date:** 07/18/2008
- **Last updated:** 10/27/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 207705903 | — | TX |
| 05 | — | 207705904 | — | TX |