Provider Demographics
NPI:1528182581
Name:POHL, BLANCA LEON (APRN)
Entity Type:Individual
Prefix:
First Name:BLANCA
Middle Name:LEON
Last Name:POHL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:BLANCA
Other - Middle Name:LUZ
Other - Last Name:RIGGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:7958 RED BIRCH CIR
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29418-3190
Mailing Address - Country:US
Mailing Address - Phone:843-714-0667
Mailing Address - Fax:
Practice Address - Street 1:2294 OTRANTO RD
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-9603
Practice Address - Country:US
Practice Address - Phone:843-225-2550
Practice Address - Fax:843-225-2590
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP10531363LF0000X
SC17555363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CANP 10531OtherNURSE PRACTITIONER LIC
SC17555OtherSOUTH CAROLINA APRN LICENSE
CARN551478Medicaid
MR2266484OtherDEA
CARN551478Medicaid