Tierra Elonda Blackmon
Nurse Practitioner Nurse Practitioner - Family Medicine
5323 Harry Hines Blvd
Dallas
, Texas 75390-7208
Tierra Elonda Blackmon
Nurse Practitioner Nurse Practitioner - Family Medicine
5323 Harry Hines Blvd
Dallas
, Texas 75390-7208
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About
Features
Specialties
- Nurse Practitioner
- Nurse Practitioner - Family Medicine
Languages spoken
- English
Location
First Address
- Tierra Elonda Blackmon
- Po Box 845347
- Dallas, TX
- Zip : 75248-7208
- Phone :
Second Address
- Tierra Elonda Blackmon
- 5323 Harry Hines Blvd
- Dallas, TX
- Zip : 75390-7208
- Phone : (214) 633-5555
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Is Tierra Elonda Blackmon a sole practitioner?
Is Tierra Elonda Blackmon accepting new patients?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 901816 | MS |
| Y | 363LF0000X | Nurse Practitioner - Family Medicine | AP132292 | TX |
National Provider Identifier
| NPI | 1003261363 |
|---|---|
| Provider Name | Tierra Elonda Blackmon |
| First Address | Dallas, TX 75248-7208 |
| Second Address | Dallas, TX 75390-7208 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 24/04/2016 |
| Last Update Date | 13/11/2019 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.