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General NPI Number Information
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NPI Number | 1730267675
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Entity Type | Individual
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Provider Name | KATHLEEN E BLANEY A.R.N.P.
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Gender | Female
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 03/23/2017
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Provider Practice Location Address
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Address Line | 650 N WYMORE RD SUITE 102
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City | WINTER PARK
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State | FL
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Zip | 32789-2859
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Country | US
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Telephone | 407-644-9002
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Fax | 407-644-9004
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Provider Business Mailing Address
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Address Line | 650 N WYMORE RD SUITE 102
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City | WINTER PARK
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State | FL
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Zip | 32789-2859
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Country | US
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Telephone | 407-644-9002
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Fax | 407-644-9004
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | ARNP2209342
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License Number State | FL
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