Provider Demographics
NPI:1366503468
Name:BLANCHARD, PATRICIA (FNP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:BLANCHARD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 CHURCH STREET
Mailing Address - Street 2:PO BOX 580
Mailing Address - City:ROSE HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28458
Mailing Address - Country:US
Mailing Address - Phone:910-289-3215
Mailing Address - Fax:
Practice Address - Street 1:600 S SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:ROSE HILL
Practice Address - State:NC
Practice Address - Zip Code:28458-0040
Practice Address - Country:US
Practice Address - Phone:910-289-3027
Practice Address - Fax:910-289-2894
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200248363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily