Individual
MRS. SUZANNE A BLANCHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1401 SHORT DRIVE, PRUDENVILLE, MI 48651-0019
(989) 366-1515
Mailing address
1401 SHORT DRIVE, PRUDENVILLE, MI 48651-0019
(989) 366-1515
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
4704203066
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4577440 TYPE 10
—
MI
01
—
5008702190
BLUE CROSS BLUE SHIELD
MI
Enumeration date
07/05/2005
Last updated
03/07/2023
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