Provider Demographics
NPI:1104814961
Name:BLANCHARD, COLETTE MARIE (ANP-C, MSN)
Entity type:Individual
Prefix:MS
First Name:COLETTE
Middle Name:MARIE
Last Name:BLANCHARD
Suffix:
Gender:F
Credentials:ANP-C, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 RUE DE LA VIE ST
Mailing Address - Street 2:SUITE 310
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70817-5127
Mailing Address - Country:US
Mailing Address - Phone:225-201-0505
Mailing Address - Fax:225-201-9955
Practice Address - Street 1:500 RUE DE LA VIE ST
Practice Address - Street 2:SUITE 310
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70817-5127
Practice Address - Country:US
Practice Address - Phone:225-201-0505
Practice Address - Fax:225-201-9955
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAPO4064363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health