Provider Demographics
NPI:1467114397
Name:NOBLITT, PAUL CHRISTOPHER (APRN)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:CHRISTOPHER
Last Name:NOBLITT
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 CLARK SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-3639
Mailing Address - Country:US
Mailing Address - Phone:817-946-1134
Mailing Address - Fax:
Practice Address - Street 1:3410 WORTH ST STE 540
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-2079
Practice Address - Country:US
Practice Address - Phone:214-820-6856
Practice Address - Fax:214-820-1474
Is Sole Proprietor?:No
Enumeration Date:2021-10-07
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1056139364ST0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364ST0500XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistTransplantation