Doctor Name: | MS. CHYNNA SUE BLAIR |
NPI Number: | 1457781296 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-C |
License Number: | 737378 |
Business Practice Address: | 2600 Fm 1764 Rd Suite 190 La Marque, TX - 775682824 |
Business Phone Number: | 2818868964 |
Business Fax Number: | |
Mailing Address: | 2511 Kildeer Ct, LEAGUE CITY |
State: | TX |
Postal Code: | 775734861 |
Phone Number: | 2549743033 |
Fax Number: | |
NPI Enumeration Date: | 11/14/2013 |
NPI Last Update Date: | 11/14/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 737378 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |