Provider Demographics
NPI:1720023542
Name:BLANCHARD, JANIS LEIGH (WHNP CNM)
Entity Type:Individual
Prefix:
First Name:JANIS
Middle Name:LEIGH
Last Name:BLANCHARD
Suffix:
Gender:F
Credentials:WHNP CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 S BOYLAN AVE
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27603-1802
Mailing Address - Country:US
Mailing Address - Phone:919-833-7526
Mailing Address - Fax:919-390-1384
Practice Address - Street 1:100 S BOYLAN AVE
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-1802
Practice Address - Country:US
Practice Address - Phone:919-833-7526
Practice Address - Fax:919-390-1384
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO17190367A00000X
NC676367A00000X
NC5010314363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO76683745Medicaid
MB0509743OtherDEA
CO76683745Medicaid