SHIRLEY BLANCO (NPI# 1659913606) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659913606 |
| Entity Type | Individual |
| Full Name | SHIRLEY BLANCO |
| Credential | NP-C |
| Practice Address |
800 Hospital Dr Crestview FL 32539-7385 |
| Mailing Address |
2804 Remington Green Cir Ste 2 Tallahassee FL 32308-1550 |
| Practice Telephone | 8506821164 |
| Practice Fax Number | 8506825302 |
| Mailing Telephone | 8503854494 |
| Enumeration Date | 2019-10-10 |
| Last Update Date | 2019-10-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
11004391 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
800 HOSPITAL DR |
| City | CRESTVIEW |
| State | FL |
| Zip Code | 32539-7385 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689289563 | Lauren Marie Schak | Registered Nurse | 800 Hospital Dr, Crestview, FL 32539-7385 | 2020-09-09 |
| 1508489238 | Lauren Michelle Soekirman | Dentist | 800 Hospital Dr, Crestview, FL 32539-7385 | 2020-05-28 |
| 1396384582 | Jennifer Vital Whitfield | General Practice | 800 Hospital Dr, Crestview, FL 32539-7385 | 2020-01-05 |
| 1316470065 | Patricia Haun | Dental Hygienist | 800 Hospital Dr, Crestview, FL 32539-7385 | 2017-04-10 |
| 1124564976 | Carolina Schlicker | Dental Hygienist | 800 Hospital Dr, Crestview, FL 32539-7385 | 2017-01-17 |
| 1548651870 | Sadi Ramirez | Pediatrics | 800 Hospital Dr, Crestview, FL 32539-7385 | 2015-02-09 |
| 1982920906 | North Florida Medical Centers, Inc. | Clinic/Center | 800 Hospital Dr, Crestview, FL 32539-7385 | 2010-04-15 |
| 1700044997 | Allen Pryor Vanoverbeke | Dentist | 800 Hospital Dr, Crestview, FL 32539-7385 | 2008-05-25 |
| 1194908954 | North Florida Medical Centers Inc | Clinic/Center | 800 Hospital Dr, Crestview, FL 32539-7385 | 2007-12-14 |
| 1053396002 | Terry L Payne | Family Medicine | 800 Hospital Dr, Crestview, FL 32539-7385 | 2005-12-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326418336 | Abc Pediatrics of Okaloosa | Pediatrics | 182 E. Redstone Ave, Suite B, Crestview, FL 32539 | 2015-10-02 |
| 1336498443 | Jessica Carolina Carroll | Counselor | 259 E. Oakdale Ave, Crestview, FL 32539 | 2012-09-05 |
| 1902167166 | Patricia Guess | Registered Nurse | 6011 Aubrey Lee Ln, Crestview, FL 32539 | 2012-06-05 |
| 1699048181 | Chien Nguyen | Clinical Medical Laboratory | 151 East Redstone Avenue, Crestview, FL 32539 | 2012-02-15 |
| 1043494164 | Crestview Mri | Clinic/Center | 700 Hospital Drive, Crestview, FL 32539 | 2007-12-26 |
| 1558581215 | Barnes Healthcare of Fl LLC | Durable Medical Equipment & Medical Supplies | 450 Brookmeade Dr, Crestview, FL 32539 | 2007-04-26 |
| 1568576098 | Okaloosa Youth Development Center | Substance Abuse Rehabilitation Facility | 4449 Straighline Road, Crestview, FL 32539 | 2006-08-19 |
| 1154368181 | Marcello Borzatta | Surgery | 129 E. Redstone Ave, Suite A, Crestview, FL 32539 | 2006-05-31 |
| 1902850258 | Panhandle Orthopaedics LLC | Physical Therapist | 710 Hospital Drive, Crestview, FL 32539 | 2006-05-20 |
| 1619941440 | Yale R Smith | Anesthesiology | 151 Redstone Ave Se, Pinnacle Physicians LLC, Crestview, FL 32539 | 2006-02-16 |
| Find all providers in zip 32539 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881168284 | Mary-ellen Dorathy Katrina Tinnerello | Nurse Practitioner | 4664 Browning Ct, Crestview, FL 32539-5730 | 2019-01-18 |
| 1215426846 | Emily Winona Bundrick | Nurse Practitioner | 5681 Ryan Rd, Crestview, FL 32539-8823 | 2018-05-09 |
| 1942237458 | Linda Cheryl Foley | Nurse Practitioner | 109 Old South Dr, Crestview, FL 32536-5565 | 2006-06-28 |
| 1326607276 | Brittany Marie Arbacheski Fais | Nurse Practitioner | 369 N Main St, Crestview, FL 32536-3541 | 2019-06-12 |
| 1548726136 | Tanya Tamika Jenkins | Nurse Practitioner | 210 S Main St, Crestview, FL 32536-3737 | 2019-02-19 |
| 1689144198 | Kayla Scott | Nurse Practitioner | 151 E Redstone Ave, Crestview, FL 32539-5352 | 2018-11-27 |
| 1013434570 | Brittany Nicole Grimes | Nurse Practitioner | 129 E Redstone Ave Ste A, Crestview, FL 32539-5350 | 2017-08-25 |
| 1821510835 | Melissa Dianne Davis | Nurse Practitioner | 151 E Redstone Ave, Crestview, FL 32539-5352 | 2017-07-11 |
| 1013377720 | Michelle Therese Koski | Nurse Practitioner | 302 E James Lee Blvd, Crestview, FL 32539-2827 | 2016-02-24 |
| 1457766214 | Lindsey Alaina Mann-badyrka | Nurse Practitioner | 332 Medcrest Dr, Crestview, FL 32536-6440 | 2014-06-30 |
| Find all providers in CRESTVIEW | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.