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General NPI Number Information
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NPI Number | 1699930628
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Entity Type | Individual
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Provider Name | MARY ZOE BLACKBURN RN, CNS-MS-BC
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Gender | Female
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Dates
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Enumeration Date | 07/18/2008
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 351 CYPRESS CREEK RD SUITE 201
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City | CEDAR PARK
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State | TX
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Zip | 78613-4528
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Country | US
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Telephone | 512-416-7246
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Fax | 512-275-2833
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Provider Business Mailing Address
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Address Line | 2501 W WILLIAM CANNON DR STE 401
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City | AUSTIN
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State | TX
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Zip | 78745-5278
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Country | US
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Telephone | 512-416-7246
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Fax | 512-275-2833
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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 | 364SM0705X
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Taxonomy Name | Medical-Surgical Clinical Nurse Specialist
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License Number | AP111190
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP111190
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 364S00000X
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Taxonomy Name | Clinical Nurse Specialist
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License Number | AP111190
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License Number State | TX
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