Individual
KATE LUCILLE BLANCHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
489 STATE ST, BANGOR, ME 04401-6616
(207) 973-7000
Mailing address
1203 N 25TH ST APT 2, PHILADELPHIA, PA 19121-4822
(207) 991-7759
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/25/2022
Last updated
08/16/2022
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