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
II. Dates (important events)
Enumeration Date: 10/21/2005
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8787 BRYAN DAIRY RD STE 210
LARGO FL
33777-1253
US
IV. Provider business mailing address
PO BOX 102222
ATLANTA GA
30368-2222
US
V. Phone/Fax
- Phone: 727-397-9641
- Fax: 727-393-4194
- Phone: 239-274-8200
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LA2200X |
| Taxonomy | Adult Health Nurse Practitioner |
| License Number | APRN3284982 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | APRN3284982 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: