MEDICARE: MRS. NATALIE BREAUX BLANCHARD PMHNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	AP03677	LA
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP03677	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265437438
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NATALIE BREAUX BLANCHARD PMHNP

Provider Business Mailing Address
First Line	:	805 ALBERTSON PKWY STE A
Second Line	:
City	:	BROUSSARD
State	:	LA
Zip	:	70518-4350
Country	:	US
Telephone Number	:	337-337-3304
Fax Number	:

Provider Business Practice Location Address
First Line	:	805 ALBERTSON PKWY STE A
Second Line	:
City	:	BROUSSARD
State	:	LA
Zip	:	70518-4350
Country	:	US
Telephone Number	:	337-330-4730
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	03/11/2022

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