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General NPI Number Information
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NPI Number | 1871302190
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Entity Type | Individual
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Provider Name | KIMBERLY ANN BLANCHARD APRN
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Gender | Female
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Dates
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Enumeration Date | 01/01/2025
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Last Update Date | 01/01/2025
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Provider Practice Location Address
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Address Line | 6316 S RAINBOW BLVD STE 100
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City | LAS VEGAS
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State | NV
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Zip | 89118-3233
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Country | US
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Telephone | 702-310-9350
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Fax |
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Provider Business Mailing Address
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Address Line | 10667 MYSTIC SEAPORT AVE
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City | LAS VEGAS
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State | NV
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Zip | 89129-3240
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Country | US
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Telephone | 702-468-4784
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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 | 885178
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License Number State | NV
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