MEDICARE: NICOLLETTE OWENS-BLANN CRNP

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	363LA2100X	Acute Care Nurse Practitioner	SP035379	PA

General Provider Information

NPI Number	:	1437006483
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLLETTE OWENS-BLANN CRNP

Provider Business Mailing Address
First Line	:	31 N DANBURY CIR
Second Line	:
City	:	COATESVILLE
State	:	PA
Zip	:	19320-5612
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	531 MAPLE AVE
Second Line	:
City	:	WEST CHESTER
State	:	PA
Zip	:	19380-4416
Country	:	US
Telephone Number	:	610-692-4382
Fax Number	:

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

Provider Enumeration Date	:	03/10/2026
Last Update Date	:	03/10/2026

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