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Individual

MARY P BLANCHET

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
2920 N ARLINGTON AVE, SUITE B, INDIANAPOLIS, IN 46218-3362
(317) 355-9431
(317) 355-9445
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2890
(317) 355-2700
(317) 355-9445

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71000008A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000542851
ANTHEM
IN
05
200063950
IN
01
P01157037
MEDICARE RR
IN
Enumeration date
07/20/2006
Last updated
01/31/2017
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