Individual
MRS. LEISA DAWN BLANCHARD
Active
Individual
MRS. LEISA DAWN BLANCHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
142484
MO
363LF0000X
Family Nurse Practitioner
Primary
2015034072
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1861693640
—
MO
05
—
359160504
—
MO
Enumeration date
05/30/2007
Last updated
02/08/2016
Update your record
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