Individual
TERESSA BLANCHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1865 TAMARACK RD, NEWARK, OH 43055
(220) 564-4934
(220) 564-4944
Mailing address
1865 TAMARACK RD, NEWARK, OH 43055
(220) 564-4934
(220) 564-4944
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
COA.19268-NP
OH
363LP0200X
Pediatric Nurse Practitioner
Primary
APRN.CNP.19268
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0177111
—
OH
Enumeration date
06/22/2016
Last updated
03/18/2021
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