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General NPI Number Information
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NPI Number | 1528078078
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Entity Type | Individual
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Provider Name | EUGENIA M. BLOMSTROM RN, CNS,PMH
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Gender | Female
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 06/12/2009
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Provider Practice Location Address
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Address Line | 616 W RUSSELL PL
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City | SAN ANTONIO
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State | TX
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Zip | 78212-3658
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Country | US
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Telephone | 800-257-8715
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Fax | 800-819-1655
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Provider Business Mailing Address
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Address Line | 7503 FOSTER CREEK DR
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City | RICHMOND
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State | TX
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Zip | 77469-9766
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Country | US
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Telephone | 800-257-8715
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Fax | 800-819-1655
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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 | 364SP0808X
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Taxonomy Name | Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 227021
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License Number State | TX
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