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Individual

MRS. COURTNEY B BLACKWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, MSN, AGNP AANP-C

Contact information

Practice address
1000 CRAIG DR, AMARILLO, TX 79106-4015
(806) 331-7905
(806) 731-1516
Mailing address
PO BOX 847692, DALLAS, TX 75284-7692
(806) 331-7905
(806) 731-1516

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP126365
TX
363LA2200X
Adult Health Nurse Practitioner
AP126365
TX
363LG0600X
Gerontology Nurse Practitioner
AP126365
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3456659-01
TX
Enumeration date
04/29/2015
Last updated
02/16/2016
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