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General NPI Number Information
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NPI Number | 1083275697
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Entity Type | Individual
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Provider Name | IANNA BLANCHARD MD
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Gender | Female
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Dates
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Enumeration Date | 06/25/2019
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Last Update Date | 06/12/2025
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Provider Practice Location Address
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Address Line | 800 ROSE ST FL 1
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City | LEXINGTON
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State | KY
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Zip | 40536-6035
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Country | US
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Telephone | 859-562-1085
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Fax | 859-257-5152
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Provider Business Mailing Address
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Address Line | ETSU DEPARTMENT OF PEDIATRICS DOGWOOD AVE BUILDING 1 BOX 70578
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City | JOHNSON CITY
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State | TN
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Zip | 37614
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Country | US
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Telephone | 423-439-6763
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Fax | 423-439-8066
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 56595
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License Number State | KY
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