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General NPI Number Information
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NPI Number | 1467839324
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Entity Type | Individual
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Provider Name | COURTNEY B BLACKWELL RN, MSN, AGNP AANP-C
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Gender | Female
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Dates
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Enumeration Date | 04/29/2015
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Last Update Date | 02/16/2016
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Provider Practice Location Address
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Address Line | 1000 CRAIG DR
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City | AMARILLO
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State | TX
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Zip | 79106-4015
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Country | US
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Telephone | 806-331-7905
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Fax | 806-731-1516
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Provider Business Mailing Address
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Address Line | PO BOX 847692
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City | DALLAS
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State | TX
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Zip | 75284-7692
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Country | US
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Telephone | 806-331-7905
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Fax | 806-731-1516
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | AP126365
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | AP126365
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP126365
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License Number State | TX
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