Jean Marie Blascoe, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

9366764 Issued in FL

Practice address

3830 Evans Ave
Fort Myers, FL 33901-9305

Phone

(239) 939-2808

Fax

(239) 939-4794

NPI assigned

Jun 13, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1213315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420156800000",
    "number": "1093975948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14790 EAGLE RIDGE DR",
            "address_2": "APT 102",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339121791",
            "telephone_number": "815-494-0623",
            "fax_number": "239-939-4794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3830 EVANS AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019305",
            "telephone_number": "239-939-2808",
            "fax_number": "239-939-4794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLASCOE",
        "first_name": "JEAN",
        "middle_name": "MARIE",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-13",
        "last_updated": "2015-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IL",
            "license": "309003042",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "9366764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Jeremy Blakemore, P.A.
• Stephanie Nicole Blakeslee, APRN
• Yoan Blanco Sanchez, DMD
• Merritt Blandford, LCSW
• Jillian Blas
• Alissa Blasini, PHARMD
• Wilfredo Blasini, M.D.
• Francesca Blazekovic, MD
• BLC Fort Myers-GC, LLC
• Jessica Ruth Yost Bledsoe, LCSW

• Pediatric Nurse Practitioner in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Pediatric Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.