Provider Demographics
NPI:1932613957
Name:BLANGSTED, BETTY JEAN (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:BETTY
Middle Name:JEAN
Last Name:BLANGSTED
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:MRS
Other - First Name:BJ
Other - Middle Name:
Other - Last Name:BLANGSTED
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP-C
Mailing Address - Street 1:PO BOX 43100
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85733-3100
Mailing Address - Country:US
Mailing Address - Phone:520-885-2072
Mailing Address - Fax:520-721-9464
Practice Address - Street 1:6268 E GRANT RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-5882
Practice Address - Country:US
Practice Address - Phone:520-885-2072
Practice Address - Fax:520-721-9464
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-29
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10773363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner