Individual
BRANDON SHEA BLANCHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
1701 OAK PARK BLVD, LAKE CHARLES, LA 70601-8911
(337) 494-3036
Mailing address
411 PISTOL DR, LAKE CHARLES, LA 70611-4747
(337) 302-4528
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APO9872
LA
Other
Enumeration date
03/21/2018
Last updated
03/21/2018
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