Chynna Sue Blair, FNP-C

Individual provider Active NPI Family Nurse Practitioner · La Marque, TX

NPI 1457781296 · NPPES record last updated Nov 14, 2013

Key facts

NPI
1457781296
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
737378 (TX)
Practice address
2600 FM 1764 Rd
Suite 190
La Marque, TX 77568-2824
Phone
(281) 886-8964
NPI assigned
Nov 14, 2013
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
737378TXMDFamily Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 737378 TX Yes

Addresses

Primary practice location

2600 FM 1764 Rd
Suite 190
La Marque, TX 77568-2824

Mailing address

2511 Kildeer CT
League City, TX 77573-4861
Phone (254) 974-3033

Other providers in La Marque, TX

All providers in La Marque, TX · Family Nurse Practitioner in Texas

Sources for this page

Verify at the official NPI Registry.