Individual
KATHERINE LINDSEY BLALOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
6100 HARRIS PKWY STE 285, FORT WORTH, TX 76132-4127
(817) 263-5864
(817) 394-3994
Mailing address
1201 FAIRMOUNT AVE, FORT WORTH, TX 76104-4215
(817) 335-5288
(817) 338-0927
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
1003334
TX
363LA2100X
Acute Care Nurse Practitioner
1003334
TX
363LG0600X
Gerontology Nurse Practitioner
Primary
1003334
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003334
NURSE PRACTITIONER LICENSE
TX
01
—
831405
RN LICENSE
TX
Enumeration date
11/09/2020
Last updated
01/19/2026
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