Provider Demographics
NPI:1194442970
Name:BLANC, MYRLANDE (RN)
Entity type:Individual
Prefix:
First Name:MYRLANDE
Middle Name:
Last Name:BLANC
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:169 W HARTFORD AVE
Mailing Address - Street 2:
Mailing Address - City:UXBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01569-1123
Mailing Address - Country:US
Mailing Address - Phone:978-453-8261
Mailing Address - Fax:
Practice Address - Street 1:100 CROSSING BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-5555
Practice Address - Country:US
Practice Address - Phone:888-964-6681
Practice Address - Fax:888-662-0859
Is Sole Proprietor?:No
Enumeration Date:2022-10-24
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA206938163W00000X
MARN206938363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse