Individual
ANGELICA MARIA BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4055 VALLEY VIEW LN STE 700, DALLAS, TX 75244-5045
(972) 715-3800
Mailing address
PO BOX 1385, OZARK, MO 65721-1385
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2019007961
MO
Other
Enumeration date
02/07/2019
Last updated
08/18/2021
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