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1174801138
SHANNON BLACKSTOCK
AUSTIN, TX
NPI
1174801138
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0200X Nurse Practitioner, Pediatrics
(Licence: TX 731190)
Enumeration Date
2011-07-25
Last Update Date
2012-02-29
Business Address
Mrs. SHANNON BLACKSTOCK RN, CPNP
1301 BARBARA JORDAN BLVD SUITE 200
AUSTIN, TX 78723-3077
Phone number: 512-628-1850
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Mailing Address
Mrs. SHANNON BLACKSTOCK RN, CPNP
1301 BARBARA JORDAN BLVD SUITE 200
AUSTIN, TX 78723-3077
Phone number:
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