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NPI Code Detail

MEDICARE: TAMARA NICOLE BLANTON APRN, FNP-C

MEDICARE:   TAMARA NICOLE BLANTON  APRN, FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner1135586TX

General Provider Information

NPI Number : 1558148015
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAMARA NICOLE BLANTON APRN, FNP-C
Provider Business Mailing Address
First Line : 14547 LAKE BUSINESS DR STE 404
Second Line :
City : CONROE
State : TX
Zip : 77304-3251
Country : US
Telephone Number : 936-233-9488
Fax Number : 844-689-5159
Provider Business Practice Location Address
First Line : 14547 LAKE BUSINESS DR STE 404
Second Line :
City : CONROE
State : TX
Zip : 77304-3251
Country : US
Telephone Number : 936-233-9488
Fax Number : 936-237-1362
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2023
Last Update Date : 05/22/2026

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Directions to “ TAMARA NICOLE BLANTON APRN, FNP-C” Practice Location

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