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Amanda R Blalock, NP
Psychiatric/Mental Health Nurse Practitioner in Tyler, Texas
NPI 1740681279

Amanda R Blalock is a Psychiatric/Mental Health Nurse Practitioner based in Tyler, TX and is specialized in Psychiatric/Mental Health. Amanda R Blalock practices in Tyler, TX and has the professional credentials of NP. The NPI Number for Amanda R Blalock is 1740681279 and holds a License No. AP144205 (Texas).

The current practice location address for Amanda R Blalock is 1800 Shiloh Rd Ste 104, Tyler, TX and can be reached out via phone at 903-969-5125 and via fax at 207-536-2445.

Location: 1800 Shiloh Rd Ste 104, Tyler, TX, 75703-2456
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Provider Profile Details
NPI Number
1740681279
Provider Name
Amanda R Blalock
Credential
NP
Provider Entity Type
Individual
Gender
Female
Address
1800 Shiloh Rd Ste 104, Tyler, TX, 75703-2456
Phone Number
903-969-5125
Fax Number
207-536-2445
Provider Enumeration Date
09/16/2014
Last Update Date
10/19/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
407984001 05 TX
institution
Provider Business Practice Location Address Details
Address
1800 Shiloh Rd Ste 104
City
State
Zip
75703-2456
Phone Number
903-969-5125
Fax Number
207-536-2445
person
Provider Business Mailing Address Details
Address
1800 Shiloh Rd Ste 104
City
State
Zip
75703-2456
Phone Number
903-969-5125
Fax Number
207-536-2445
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
License No.
AP144205 (Texas)
Definition
Definition to come...
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