=====================================================
General NPI Number Information
=====================================================
NPI Number | 1538264163
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RICHELLE BLANCHARD MSN, FNP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/14/2006
-----------------------------------------------------
Last Update Date | 06/26/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 972 N 600 E
-----------------------------------------------------
City | SPANISH FORK
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84660-1306
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 385-265-6060
-----------------------------------------------------
Fax | 801-367-6930
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 835 N 640 W
-----------------------------------------------------
City | AMERICAN FORK
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84003-5244
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 801-367-6930
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | 327776-4405
-----------------------------------------------------
License Number State | UT
-----------------------------------------------------