Blackburn, Mary Zoe

Blackburn, Mary Zoe is an individual health care provider with primary practice located at 351 Cypress Creek Rd Suite 201, Cedar Park TX 78613-4528. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Clinical Nurse Specialist, Physician Assistants & Advanced Practice Nursing Providers / Medical-Surgical, Physician Assistants & Advanced Practice Nursing Providers / Adult Health. Physician Assistants & Advanced Practice Nursing Providers / Adult Health is her primary health care specialty. Blackburn, Mary Zoe can be contacted via phone (512) 416-7246.

Contact Information

Primary practice address
351 Cypress Creek Rd Suite 201 Cedar Park TX 78613-4528
Phone: (512) 416-7246
Fax: (512) 275-2833
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Clinical Nurse Specialist 364S00000X AP111190 Texas
Physician Assistants & Advanced Practice Nursing Providers / Medical-Surgical 364SM0705X AP111190 Texas
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X AP111190 Texas

Profile Details

NPI number 1699930628
LBN Legal business name Blackburn, Mary Zoe
Credentials RN, CNS-MS-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2008
Last updated Jul 12th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699930628 NPPES
Texas MEDICAID 207705903
Texas MEDICAID 207705904

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