Individual
PATRICIA V BLANC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
727 HONEYSPOT RD, STRATFORD, CT 06615-7172
(203) 375-7242
(203) 375-2318
Mailing address
982 E MAIN ST, BRIDGEPORT, CT 06608-1913
(203) 696-3260
(203) 375-2318
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
004186
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4186
CT LICENSE
CT
Enumeration date
09/02/2009
Last updated
04/19/2016
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