Provider Demographics
NPI:1710357280
Name:LABLANCE, TERRI (NP)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:
Last Name:LABLANCE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3905 BERNARD POWELL DR
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64127-3427
Mailing Address - Country:US
Mailing Address - Phone:816-799-2223
Mailing Address - Fax:816-214-5250
Practice Address - Street 1:3905 BERNARD POWELL DR
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64127-3427
Practice Address - Country:US
Practice Address - Phone:816-799-2223
Practice Address - Fax:816-214-5250
Is Sole Proprietor?:No
Enumeration Date:2015-09-28
Last Update Date:2015-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015034097363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health