| Doctor Name: | MS. MARY ZOE BLACKBURN |
| NPI Number: | 1699930628 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN, CNS-MS-BC |
| License Number: | AP111190 |
| Business Practice Address: | 351 Cypress Creek Rd Suite 201 Cedar Park, TX - 786134528 |
| Business Phone Number: | 5124167246 |
| Business Fax Number: | 5122752833 |
| Mailing Address: | 2501 W William Cannon Dr, Suite 401 AUSTIN |
| State: | TX |
| Postal Code: | 787455281 |
| Phone Number: | 5124167246 |
| Fax Number: | 5122752833 |
| NPI Enumeration Date: | 07/18/2008 |
| NPI Last Update Date: | 02/15/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 364S00000X |
| License Number: | AP111190 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Clinical Nurse Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A registered nurse who, through a graduate degree program in nursing, or through a formal post-basic education program or continuing education courses and clinical experience, is expert in a specialty area of nursing practice within one or more of the components of direct patient/client care, consultation, education, research and administration. |