Individual
BLANCA L. PACCHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C, MPH
Contact information
Practice address
950 CAMPBELL AVE BLDG 2B, WEST HAVEN, CT 06516
(203) 932-5711
(203) 937-4808
Mailing address
400 COLUMBUS AVENUE, CREDENTIALING SPECIALIST, NEW HAVEN, CT 06519-1233
(203) 503-3174
(203) 503-6515
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
7678
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/19/2018
Last updated
09/04/2019
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