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General NPI Number Information
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NPI Number | 1801247168
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Entity Type | Individual
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Provider Name | DANA MORAY BLAIR CPNP
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Gender | Female
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Dates
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Enumeration Date | 06/28/2016
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | 4300 W UNIVERSITY DR STE 10
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City | PROSPER
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State | TX
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Zip | 75078-9806
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Country | US
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Telephone | 682-303-8050
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Fax | 682-303-8052
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Provider Business Mailing Address
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Address Line | PO BOX 733784
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City | DALLAS
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State | TX
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Zip | 75373-3784
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Country | US
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Telephone | 682-885-6483
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Fax | 682-885-3113
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 746797
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | AP131571
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License Number State | TX
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