Provider Demographics
NPI:1124730569
Name:BLACKMAN, BRITTANY (FNP-BC)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:BLACKMAN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4324 MAPLESHADE LN STE 202
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-0044
Mailing Address - Country:US
Mailing Address - Phone:214-984-0549
Mailing Address - Fax:949-695-4138
Practice Address - Street 1:4324 MAPLESHADE LN # 202
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-0044
Practice Address - Country:US
Practice Address - Phone:214-984-0549
Practice Address - Fax:949-695-4138
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-16
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1100709363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily