Individual
JEAN CLAUDE BLANCHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1320 MARTIN LUTHER KING DR, THIBODAUX, LA 70301-4886
(985) 446-2021
(985) 447-1546
Mailing address
PO BOX 4176, HOUMA, LA 70361-4176
(985) 876-0300
(985) 872-0317
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP07462
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2348078
—
LA
Enumeration date
07/12/2013
Last updated
10/08/2014
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