Healthcare Provider Details

I. General information

NPI: 1891053211
Provider Name (Legal Business Name): BLANCHE AFOLABI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2012
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 PENN ST
HANOVER PA
17331-1928
US

IV. Provider business mailing address

120 PENN ST
HANOVER PA
17331-1928
US

V. Phone/Fax

Practice location:
  • Phone: 717-969-8400
  • Fax:
Mailing address:
  • Phone: 717-969-8400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR199835
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberL8-0010913
License Number StateDE
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberSP030413
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: