Healthcare Provider Details

I. General information

NPI: 1316936347
Provider Name (Legal Business Name): HEATHER D BLANCHETTE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEATHER LEHING ARNP

II. Dates (important events)

Enumeration Date: 10/21/2005
Last Update Date: 09/19/2022
Certification Date: 09/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HIGHLAND AVE N
LARGO FL
33770-2542
US

IV. Provider business mailing address

PO BOX 102222
ATLANTA GA
30368-2222
US

V. Phone/Fax

Practice location:
  • Phone: 727-683-2900
  • Fax: 727-683-2901
Mailing address:
  • Phone: 239-274-8200
  • Fax: 239-278-3350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN3284982
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: