Provider Demographics
NPI:1851524524
Name:BLANCHARD, PAMELA J (NP)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:J
Last Name:BLANCHARD
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 1:5839 HARBOUR VIEW BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435-3797
Mailing Address - Country:US
Mailing Address - Phone:757-483-6100
Mailing Address - Fax:757-483-2203
Practice Address - Street 1:3000 COLISEUM DR STE 205
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-5963
Practice Address - Country:US
Practice Address - Phone:757-827-2550
Practice Address - Fax:855-939-7186
Is Sole Proprietor?:No
Enumeration Date:2009-08-28
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024168458363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner