MEDICARE: PAMELA BLANCHE FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	143114	TX

General Provider Information

NPI Number	:	1962044727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAMELA BLANCHE FNP

Provider Business Mailing Address
First Line	:	13701 HYCOHEN RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77047-4522
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	13701 HYCOHEN RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77047-4522
Country	:	US
Telephone Number	:	504-259-9895
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/14/2019
Last Update Date	:	10/14/2019

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Directions to “ PAMELA BLANCHE FNP” Practice Location

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