Individual
ERIN FAVRE BLANCHETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
618 BLUE MEADOW RD, CHILDREN'S INTERNATIONAL MEDICAL GROUP, BAY ST LOUIS, MS 39520-2834
(228) 467-1320
Mailing address
618 BLUE MEADOW RD, BAY ST LOUIS, MS 39520-2834
(228) 467-1320
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
R870090
MS
Other
Enumeration date
04/27/2012
Last updated
02/19/2016
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