Individual
ROXANNE BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2692 BRADLEY LN, ROUND ROCK, TX 78664-4596
(936) 524-4071
Mailing address
2692 BRADLEY LN, ROUND ROCK, TX 78664-4596
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
937216
TX
363L00000X
Nurse Practitioner
Primary
1139030
TX
Other
Enumeration date
07/12/2023
Last updated
02/17/2024
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