Tamria Denise Blackley, CPNP-PC Valid NPI

Individual provider · Specialist · Lake Jackson, TX

NPI

1457625345

Type

Individual (Type 1)

Primary specialty

Specialist

Specialty group

Other Service Providers

Taxonomy code

174400000X

License number

715129 (TX)

Sex

Female

Sole proprietor

No

Enumerated

2012-02-24

Last updated

2012-07-25