Individual
JEAN MARIE BLASCOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
3830 EVANS AVE, FORT MYERS, FL 33901-9305
(239) 939-2808
(239) 939-4794
Mailing address
14790 EAGLE RIDGE DR, APT 102, FORT MYERS, FL 33912-1791
(815) 494-0623
(239) 939-4794
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
309003042
IL
363LP0200X
Pediatric Nurse Practitioner
Primary
9366764
FL
Other
Enumeration date
06/13/2008
Last updated
01/02/2015
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