TIERRA ELONDA BLACKMON

DALLAS, TX
NPI1003261363
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: TX  AP132292)
Additional Taxonomies363L00000X Nurse Practitioner
(Licence: MS  901816)
Enumeration Date2016-04-24
Last Update Date2019-11-13
Business Address
TIERRA ELONDA BLACKMON
5323 HARRY HINES BLVD
DALLAS, TX 75390-7208
Phone number: 214-633-5555
Mailing Address
TIERRA ELONDA BLACKMON
PO BOX 845347
DALLAS, TX 75248-7208
Phone number: