person
Leisha Monette Blaylock, FNP-C
Family Nurse Practitioner in Bridgeport, Texas
NPI 1083018063

Leisha Monette Blaylock is a Family Nurse Practitioner based in Decatur, TX and is specialized in Family. Leisha Monette Blaylock practices in Bridgeport, TX and has the professional credentials of FNP-C. The NPI Number for Leisha Monette Blaylock is 1083018063 and holds a License No. AP126686 (Texas).

The current practice location address for Leisha Monette Blaylock is 2202 Us Highway 380, Bridgeport, TX and can be reached out via phone at 940-683-2338 and via fax at 940-683-2394.

Location: 2202 Us Highway 380, Bridgeport, TX, 76234
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Provider Profile Details
NPI Number
1083018063
Provider Name
Leisha Monette Blaylock
Credential
FNP-C
Provider Entity Type
Individual
Gender
Female
Address
2202 Us Highway 380, Bridgeport, TX, 76234
Phone Number
940-683-2338
Fax Number
940-683-2394
Provider Enumeration Date
10/20/2014
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
8397NM 01 TX BCBS
342225501 05 TX
institution
Provider Business Practice Location Address Details
Address
2202 Us Highway 380
City
State
Zip
76426-2176
Phone Number
940-683-2338
Fax Number
940-683-2394
person
Provider Business Mailing Address Details
Address
2202 Us Highway 380
City
State
Zip
76426-2176
Phone Number
940-683-2338
Fax Number
940-683-2394
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
AP126686 (Texas)
Definition
Definition to come...
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