Individual
ALICE T BLACKMON
Active
Individual
ALICE T BLACKMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP-C
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
AP108315
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1265413264
ALICE BLACKMON, PNP-C NPI#
TX
01
—
1508813494
GROUP PRACTICE/BILLING NPI#
TX
01
—
193200000X
GRP TAXONOMY
TX
01
—
363LP0200X
INDIVIDUAL TAXONOMY
TX
01
—
AP108315
LICENSE
TX
Enumeration date
11/08/2005
Last updated
03/09/2026
Update your record
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