Dorothy Blanton, LPN

Individual provider Active NPI Licensed Practical Nurse · Tolleson, AZ

NPI 1104248905 · NPPES record last updated Jan 13, 2014

Key facts

NPI
1104248905
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
LP030212 (AZ)
Practice address
10207 W Country Place Blvd
Tolleson, AZ 85353-8450
Phone
(623) 478-6110
NPI assigned
Jan 13, 2014
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LP030212AZMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LP030212 AZ Yes

Addresses

Primary practice location

10207 W Country Place Blvd
Tolleson, AZ 85353-8450

Mailing address

10207 W Country Place Blvd
Tolleson, AZ 85353-8450
Phone (623) 478-6110

Other providers in Tolleson, AZ

All providers in Tolleson, AZ · Licensed Practical Nurse in Arizona

Sources for this page

Verify at the official NPI Registry.