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General NPI Number Information
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NPI Number | 1801782685
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Entity Type | Organization
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Legal Business Name | FLOURISH AND BLOOM, A NURSING PC
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Dates
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Enumeration Date | 06/17/2025
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 17301 SILVER SPUR DR
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City | TUOLUMNE
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State | CA
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Zip | 95379-9638
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Country | US
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Telephone | 214-862-3471
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Fax |
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Provider Business Mailing Address
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Address Line | 17301 SILVER SPUR DR
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City | TUOLUMNE
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State | CA
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Zip | 95379-9638
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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 | CEO & PRESIDENT
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Name | MADELYN BLAIR
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Credential |
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Telephone | 214-862-3471
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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