BLANCHE L. ETHERIDGE (NPI# 1871978148) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871978148 |
| Entity Type | Individual |
| Full Name | BLANCHE L. ETHERIDGE |
| Credential | RN, BSN, AGNP |
| Practice Address |
4750 Waters Ave Suite 202 Savannah GA 31404-6200 |
| Practice Telephone | 9123507412 |
| Practice Fax Number | 9123507297 |
| Mailing Telephone | 9123507412 |
| Mailing Fax Number | 9123507297 |
| Enumeration Date | 2015-07-28 |
| Last Update Date | 2018-06-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | RN170986 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
RN170986 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
RN170986 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | PENDING | 05 |
| Street Address |
4750 WATERS AVE SUITE 202 |
| City | SAVANNAH |
| State | GA |
| Zip Code | 31404-6200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538168109 | Jill Katrice Beckworth | Nurse Practitioner | 4750 Waters Ave, Suite 202, Savannah, GA 31404-6200 | 2005-07-18 |
| 1881177954 | Holly Nicole Klepek | Genetic Counselor, MS | 4750 Waters Ave, Savannah, GA 31404-6200 | 2018-09-13 |
| 1477001659 | Sabrina Renee Williams | Genetic Counselor, MS | 4750 Waters Ave, Suite 302, Savannah, GA 31404-6200 | 2016-09-15 |
| 1871974923 | Joshua Milby | Physician Assistant | 4750 Waters Ave, Ste 202, Savannah, GA 31404-6200 | 2015-06-15 |
| 1811385800 | April M Downing | Registered Nurse | 4750 Waters Ave, #206, Savannah, GA 31404-6200 | 2014-12-30 |
| 1538563408 | Rebecca Brewster | Physician Assistant | 4750 Waters Ave, Suite 202, Savannah, GA 31404-6200 | 2014-10-21 |
| 1629487855 | Patricia A Haselden | Nurse Practitioner | 4750 Waters Ave, Ste 500, Savannah, GA 31404 | 2014-08-13 |
| 1598194318 | Ashmed Vazquez Md PC | Obstetrics & Gynecology | 4750 Waters Ave, Suite 450, Savannah, GA 31404-6200 | 2013-11-02 |
| 1902145451 | Stephanie Alston | Health Educator | 4750 Waters Ave, Suite 452, Savannah, GA 31404-6200 | 2013-02-04 |
| 1649520073 | Kay S Schwerin | Nurse Practitioner | 4750 Waters Ave, Suite 500, Savannah, GA 31404-6200 | 2012-09-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043864580 | Carli A Boatright | Registered Nurse | 4750 Waters Ave Suite 206, Savannah, GA 31404 | 2019-08-01 |
| 1619530573 | Morgan Johnson | Student in an Organized Health Care Education/Training Program | Memorial Health University Medical Center, 4700 Waters Ave, Savannah, GA 31404 | 2019-04-17 |
| 1477050243 | Kevin Timperman | Student in an Organized Health Care Education/Training Program | 4700 Waters Avenus, Surgery Residency Program, Mhumc, Savannah, GA 31404 | 2018-04-09 |
| 1376048959 | Nina Jo Paletta | Student in an Organized Health Care Education/Training Program | Memorial University Medical Center, 4700 Waters Ave., Savannah, GA 31404 | 2018-03-27 |
| 1972036200 | Jose Adrian Lara Gonzalez | Student in an Organized Health Care Education/Training Program | 4700 Waters Ave, Memorial University Medical Center, Internal Medicine Residency Program, Savannah, GA 31404 | 2017-04-04 |
| 1407210396 | Lexie Hester Vaughn | Student in an Organized Health Care Education/Training Program | 1250 East 66th St, Savannah, GA 31404 | 2016-04-07 |
| 1336503291 | Miles Love | Student in an Organized Health Care Education/Training Program | 1250 East 66th Street, Savannah, GA 31404 | 2016-04-07 |
| 1134536881 | David Patch | Specialist/Technologist | Pediatric Residency Program, Memorial University, Medical Center 4700 Waters Avenue, Savannah, GA 31404 | 2014-07-15 |
| 1962846683 | Alan Danilo Zevallos | Internal Medicine | 4700 Waters Avenue, University Medical Center, Internal Medicine Residency Program, Memorial Health, Savannah, GA 31404 | 2013-04-24 |
| 1730446394 | Joshua Ryan Fann | Prosthetist | 3840 Waters Ave, Savannah, GA 31404 | 2012-04-19 |
| Find all providers in zip 31404 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437124609 | Mary-anne Roth | Nurse Practitioner | 38 Coffee Pointe Dr, Savannah, GA 31419-3169 | 2006-02-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235746009 | Jummai Folashade Akinrinmade | Nurse Practitioner | 5290 Hidden Valley Ln, Cumming, GA 30028-7024 | 2020-09-25 |
| 1396350997 | Ellen Allen | Nurse Practitioner | 8040 Highway 54, Sharpsburg, GA 30277-2112 | 2020-09-10 |
| 1588277867 | Saleta Anica Brogdon | Nurse Practitioner | 10 Muirfield Dr, Covington, GA 30016-6536 | 2020-08-26 |
| 1043828106 | Shonkeisha Byrd | Nurse Practitioner | 1160 Great River Pkwy, Lawrenceville, GA 30045-7015 | 2020-07-15 |
| 1558982272 | Irene Kamau | Nurse Practitioner | 3605 Glenbarrett Ln Ne, Marietta, GA 30066-8509 | 2020-05-05 |
| 1891324133 | Branette Young | Nurse Practitioner | 1120 Lehavre Ct, Hampton, GA 30228-3022 | 2020-04-08 |
| 1851938559 | Sandra Holloway | Nurse Practitioner | 607 Bethany St, Sparks, GA 31647-7139 | 2019-12-02 |
| 1013550508 | Monica Smart Mills | Nurse Practitioner | 8315 Champion Trl, Fairburn, GA 30213-4739 | 2019-10-28 |
| 1063053478 | Emily Elizabeth Adams | Nurse Practitioner | 887 W Marietta St Nw, Atlanta, GA 30318-5252 | 2019-10-07 |
| 1922661800 | Dorcus Healthcare Services LLC | Nurse Practitioner | 105 Greystone Dr, Guyton, GA 31312-5548 | 2019-04-17 |
| Find all providers with the same taxonomy | ||||
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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.