MARY BLALOCK NPI 1003349671

NPI Information

  • NPI: 1003349671
  • Provider Name: MARY BLALOCK
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • Address: 107 LAKE RESERVE WAY
    HOLLY SPRINGS, GA
    ZIP 30115
  • Phone: (770) 354-0471

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NPI Details

Mary Blalock is a family nurse practitioner in Holly Springs, GA. Mary Blalock NPI is 1003349671. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

107 LAKE RESERVE WAY
HOLLY SPRINGS, GA
ZIP 30115-785
Phone: (770) 354-0471

The enumeration date for this NPI number is 4/10/2017 and was last updated on 4/10/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamilyRN129711GEORGIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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