Provider Demographics
NPI:1669014593
Name:BLONDET, NEIDA L (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:NEIDA
Middle Name:L
Last Name:BLONDET
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1380 N FILLMORE ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-6464
Mailing Address - Country:US
Mailing Address - Phone:719-630-1006
Mailing Address - Fax:719-630-0688
Practice Address - Street 1:1380 N FILLMORE ST
Practice Address - Street 2:SUITE 100
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-6464
Practice Address - Country:US
Practice Address - Phone:719-630-1006
Practice Address - Fax:719-630-0688
Is Sole Proprietor?:No
Enumeration Date:2019-10-11
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN11004553207Q00000X
COC-APN.0001783-C-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine