Individual
CASSIE LYN BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
5000 HARRY HINES BLVD, HOMES GROUP, DALLAS, TX 75235-7721
(214) 590-0153
(214) 590-0172
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
687599
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203848101
—
TX
01
—
805N81
BLUE CROSS BLUE SHIELD
TX
Enumeration date
08/04/2009
Last updated
10/15/2013
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