MARY BLALOCK
NPI 1003349671
Nurse Practitioner - Family in Holly Springs, GA

Q: What is Mary Blalock's NPI number?

The NPI number for Mary Blalock is 1003349671. It was assigned to this individual provider in the NPPES registry on April 10, 2017.

Q: What is Mary Blalock's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Mary Blalock was last updated on April 10, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 10, 2017

107 LAKE RESERVE WAY, HOLLY SPRINGS, GA 30115(770) 354-0471 Get Directions Write a Review

NPPES record last updated: April 10, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Mary Blalock NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARY BLALOCK (NPI 1003349671) is an individual family provider in Holly Springs, Georgia, licensed in Georgia (RN129711) and active in the NPI registry since April 2017.

NPPES Registry Identity

NPI1003349671

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameMARY BLALOCK

Location Address107 LAKE RESERVE WAYHolly Springs, GA 30115-4785

Mailing Address107 Lake Reserve WayHolly Springs, GA 30115-4785 · (770) 354-0471

Phone(770) 354-0471

Sole ProprietorNo

Enumeration DateApril 10, 2017

✔ NPI 1003349671 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in GA · RN129711

107 LAKE RESERVE WAY, Holly Springs, GA 30115

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mary Blalock's NPI number?

The NPI number for Mary Blalock is 1003349671. It was assigned to this individual provider in the NPPES registry on April 10, 2017.

Where is Mary Blalock located?

Mary Blalock practices at 107 Lake Reserve Way, Holly Springs, GA 30115. The listed phone number is (770) 354-0471.

What is Mary Blalock's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Mary Blalock was last updated on April 10, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.