Individual
JAMIE RENAE BLACKMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
2901 4TH ST, LONGVIEW, TX 75605-5128
(903) 930-6688
Mailing address
8 OUIDA CIR, LONGVIEW, TX 75603-9611
(903) 930-6688
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1047240
TX
363LF0000X
Family Nurse Practitioner
1047240
TX
Other
Enumeration date
07/16/2021
Last updated
12/27/2022
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