Blackmon, Shawna C

Blackmon, Shawna C is an individual health care provider with primary practice located at 3816 N University Dr , Nacogdoches TX 75965-2011. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Blackmon, Shawna C can be contacted via phone (903) 939-7500.

Contact Information

Primary practice address
3816 N University Dr Nacogdoches TX 75965-2011
Phone: (903) 939-7500
Fax: (903) 939-7728
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA04131 Texas
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA04131 Texas

Profile Details

NPI number 1487641536
LBN Legal business name Blackmon, Shawna C
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 4th, 2005
Last updated Feb 24th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487641536 NPPES
Texas Other P00743048 RAILROAD MEDICARE
Texas Other 8360ND RAILROAD MEDICARE
Texas MEDICAID 206265503 RAILROAD MEDICARE
Texas MEDICAID 206265502 RAILROAD MEDICARE
Texas MEDICAID 206265504 RAILROAD MEDICARE
Texas MEDICAID 206265501 RAILROAD MEDICARE
Texas Other 8Y8693 RAILROAD MEDICARE

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