Individual
CALLIE LYNN BLANCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
6633 FOREST AVE STE 203, NEW PORT RICHEY, FL 34653-2612
(727) 849-8771
(727) 842-4962
Mailing address
14100 FIVAY RD STE 110, HUDSON, FL 34667-7159
(727) 849-8771
(727) 842-4962
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
ARNP9334731
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112062400
—
FL
Enumeration date
05/02/2018
Last updated
08/16/2022
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