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Export Provider Record NPI 1265907414
Jeanne Marie BlakesleePMHNP
Active
NPI Number1265907414
NPI TypeNPI-1 Individual
SpecialtyNurse Practitioner, Psych/Mental Health
Provider Details
NPI1265907414
NPI TypeNPI-1 Individual
StatusActive
Enumeration Date2018-10-03
Last Updated2025-06-26
Mailing Address101 W Cooperative Way, Ste 110
Georgetown, TX 78626-8209
United States
Phone: (178) 873-0595 | Fax: (817) 873-0596
📍 View Map
Primary Practice Address1100 E Southlake Blvd Ste 300
Southlake, TX 76092-6350
United States
Phone: (178) 873-0595 | Fax: (817) 873-0596
📍 View Map
Other Identifiers
IssuerStateNumberOther Issuer
Other (non-Medicare)TXAP139257APRN
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
Yes363LP0808X – Nurse Practitioner, Psych/Mental HealthTXAP139257
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About NPI 1265907414

Jeanne Marie Blakeslee PMHNP is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1265907414. The primary specialty listed is Nurse Practitioner, Psych/Mental Health. The provider is located in Southlake, TX. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2018-10-03. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1265907414?

NPI 1265907414 belongs to Jeanne Marie Blakeslee PMHNP, a Nurse Practitioner, Psych/Mental Health in Southlake, TX. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.

Is NPI 1265907414 active?

The current status of NPI 1265907414 in the NPPES registry is Active. The record was last updated on 2025-06-26.

What specialty is NPI 1265907414?

NPI 1265907414 is classified under the taxonomy Nurse Practitioner, Psych/Mental Health. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1265907414?

You can verify NPI 1265907414 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1265907414?

The primary practice address on file for NPI 1265907414 is 1100 E Southlake Blvd Ste 300, Southlake, TX 76092-6350. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1265907414 issued?

NPI 1265907414 was first issued (enumerated) on 2018-10-03. The NPPES record was last updated on 2025-06-26.

Practice Location Map

Jeanne Marie Blakeslee is located at 1100 E Southlake Blvd Ste 300, Southlake, TX. Use the map below to find directions or verify the practice location.

📍 1100 E Southlake Blvd Ste 300, Southlake, TX 76092-6350  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Jeanne Marie Blakeslee. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1265907414. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Nurse Practitioner, Psych/Mental HealthAP139257TX
Data Verified from CMS NPPES Last synced: 2026-07-29 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162