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Individual
KAITLIN JANANN BLALOCK
Active
Individual
KAITLIN JANANN BLALOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
1006425
TX
363L00000X
Nurse Practitioner
Primary
1006425
TX
363LF0000X
Family Nurse Practitioner
1006425
TX
Other
Enumeration date
04/14/2021
Last updated
09/13/2026
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