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General NPI Number Information
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NPI Number | 1316310600
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Entity Type | Individual
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Provider Name | BLAIR KUECKER MSN, APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 11/09/2015
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 4100 EVERETT STE 400
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City | KYLE
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State | TX
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Zip | 78640-6147
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Country | US
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Telephone | 512-295-1333
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Fax | 512-406-7327
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Provider Business Mailing Address
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Address Line | 6210 E HWY 290 STE 420
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City | AUSTIN
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State | TX
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Zip | 78723-1142
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024182528
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 201508620NP-PP
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP128958
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License Number State | TX
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