MRS. CICILY DIANNE CROSS-BLAIR (NPI# 1205105319) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205105319 |
| Entity Type | Individual |
| Full Name | MRS. CICILY DIANNE CROSS-BLAIR |
| Credential | FNP |
| Practice Address |
305 Cottage Rd Carthage TX 75633-1511 |
| Practice Telephone | 9036944948 |
| Mailing Telephone | 9036944948 |
| Enumeration Date | 2011-12-19 |
| Last Update Date | 2015-06-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
699855 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
305 COTTAGE RD |
| City | CARTHAGE |
| State | TX |
| Zip Code | 75633-1511 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407355860 | Carthage Hospital, LLC | Clinic/Center | 305 Cottage Rd, Carthage, TX 75633-1511 | 2018-02-12 |
| 1629314539 | East Texas Medical Center Carthage | Clinic/Center | 305 Cottage Rd, Carthage, TX 75633-1511 | 2012-12-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508039348 | Assisted Living Concepts Inc | Assisted Living Facility | 513 North Adams, Carthage, TX 75633 | 2008-04-11 |
| 1770666208 | Prakash Malviya | Pediatrics | 409 Cottage Road, Etmc, Carthage, TX 75633 | 2006-10-20 |
| 1457448011 | Johnny Edwin Majors | Dentist | 103 North Sycamore, Carthage, TX 75633 | 2006-10-06 |
| 1740374164 | Clayton H. Brakeville | Physical Therapist | 107 S. Daniels St, Carthage, TX 75633 | 2006-10-02 |
| 1205927761 | Dennis D Golden Sr. | Optometrist | 105 Cottage Rd, Carthage, TX 75633 | 2006-09-27 |
| 1770685059 | Tom M Jones | Dentist | 311 West Sabine, Carthage, TX 75633 | 2006-09-05 |
| 1124037031 | Izzy Inc | Durable Medical Equipment & Medical Supplies | 106 N Shelby St, Carthage, TX 75633 | 2006-08-07 |
| 1699705756 | Iraj Roshan | Internal Medicine | 1519 W Panola St, Carthage, TX 75633 | 2006-07-04 |
| 1073504437 | Charles Deron Lewis | Durable Medical Equipment & Medical Supplies | 310 N Adams Street, Carthage, TX 75633 | 2005-11-03 |
| 1538157300 | Slp Carthage LLC | Skilled Nursing Facility | 701 S Market St, Carthage, TX 75633 | 2005-10-06 |
| Find all providers in zip 75633 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023641990 | John Hearn | Nurse Practitioner | 147 Hogans Creek Rd, Carthage, TN 37030-6026 | 2020-02-19 |
| 1063066363 | Crystal Campbell | Nurse Practitioner | 2600 S River St, Carthage, MO 64836-9401 | 2019-07-25 |
| 1558823971 | Rosie Hutchins | Nurse Practitioner | 105 Chessie Ln, Carthage, MS 39051-3950 | 2019-04-03 |
| 1437696150 | Leslie Purvis | Nurse Practitioner | 1001 Monroe St Ste D, Carthage, NC 28327-5009 | 2017-01-20 |
| 1750738415 | Telehealthone LLC | Nurse Practitioner | 300 South Pearl Street, Carthage, MS 39051 | 2016-05-23 |
| 1891138780 | Baptist Medical Center - Leake, Inc. | Nurse Practitioner | 600 Highway 16 E, Carthage, MS 39051-4212 | 2013-04-10 |
| 1265779094 | Yvonne Danae Camper | Nurse Practitioner | 303 Ellis St, Carthage, MS 39051-3808 | 2013-01-14 |
| 1154675866 | Kimberly Sue-hicks Donze | Nurse Practitioner | 304 E Saunders St, Carthage, NC 28327-9343 | 2012-11-02 |
| 1669635926 | Randi April Watkins | Nurse Practitioner | 407 S Valley St, Carthage, MS 39051-4051 | 2008-07-08 |
| 1407928658 | Andrea D Oliver | Nurse Practitioner | 105 Cottage Rd Ste B, Carthage, TX 75633-1507 | 2006-11-14 |
| Find all providers in CARTHAGE | ||||
Please comment or provide details below to improve the information on MRS. CICILY DIANNE CROSS-BLAIR.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.