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General NPI Number Information
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NPI Number | 1760807903
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Entity Type | Individual
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Provider Name | KAREN BLANCO FNP-C
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Gender | Female
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Dates
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Enumeration Date | 02/25/2014
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Last Update Date | 02/25/2014
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Provider Practice Location Address
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Address Line | 3255 S RURAL RD
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City | TEMPE
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State | AZ
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Zip | 85282-3853
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Country | US
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Telephone | 480-829-7799
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Fax |
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Provider Business Mailing Address
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Address Line | 2618 E CHESTER DR
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City | CHANDLER
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State | AZ
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Zip | 85286-1363
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Country | US
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Telephone | 602-370-1322
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP5390
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License Number State | AZ
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