Provider Demographics
NPI:1518049576
Name:BLANCHARD, MARY MCDANIEL (NP)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:MCDANIEL
Last Name:BLANCHARD
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:3805 COMPUTER DRIVE
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-6503
Mailing Address - Country:US
Mailing Address - Phone:919-781-6200
Mailing Address - Fax:919-783-1819
Practice Address - Street 1:3805 COMPUTER DRIVE
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-6503
Practice Address - Country:US
Practice Address - Phone:919-781-6200
Practice Address - Fax:919-783-1819
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2010-02-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC940095363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q20679Medicare UPIN