Individual
MISS ANITA JANE BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RNCPNP
Contact information
Practice address
4055 LINDELL BLVD, SAINT LOUIS, MO 63108-3201
(314) 535-7701
(314) 535-0207
Mailing address
12377 MERIT DR STE 300, DALLAS, TX 75251-3126
(972) 957-3000
(972) 957-3005
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
061036
MO
363LP0200X
Pediatric Nurse Practitioner
AP133887
TX
Other
Enumeration date
04/07/2007
Last updated
09/22/2022
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