Provider Demographics
NPI:1013737071
Name:BLANCO, JOCELYNE E (APRN)
Entity type:Individual
Prefix:
First Name:JOCELYNE
Middle Name:E
Last Name:BLANCO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6510 MAIN ST APT 203
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-2256
Mailing Address - Country:US
Mailing Address - Phone:786-203-9182
Mailing Address - Fax:
Practice Address - Street 1:6510 MAIN ST APT 203
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2256
Practice Address - Country:US
Practice Address - Phone:786-203-9182
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11035927363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care