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General NPI Number Information
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NPI Number | 1902042807
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Entity Type | Individual
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Provider Name | USHIKIA SHARI BLACKMON C.N.A
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Gender | Female
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Dates
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Enumeration Date | 12/23/2008
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Last Update Date | 12/24/2008
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Provider Practice Location Address
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Address Line | 8735 POOL HILL RD.
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City | SIMONTON
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State | TX
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Zip | 77476
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Country | US
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Telephone | 281-610-8058
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Fax | 281-346-0979
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Provider Business Mailing Address
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Address Line | P.O. BOX 345
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City | SIMONTON
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State | TX
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Zip | 77476
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Country | US
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Telephone | 281-610-8058
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Fax | 281-346-0979
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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 | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | NA00698086
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License Number State | TX
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