Patricia Ann Blosser, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

245030 Issued in AZ

Practice address

Hwy 191 St RT 264
Ganado, AZ 86505

Phone

(928) 755-4559

NPI assigned

Jul 30, 2020

Last updated

Oct 4, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Tricia Guadarrama Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1596067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1649889122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13845 LARKSPUR DR",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814039388",
            "telephone_number": "607-708-3627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HWY 191 ST RT 264",
            "city": "GANADO",
            "state": "AZ",
            "postal_code": "86505",
            "telephone_number": "928-755-4559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOSSER",
        "first_name": "PATRICIA",
        "middle_name": "ANN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-30",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "245030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRICIA",
            "last_name": "GUADARRAMA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Action Medical Service Inc
• Letron R. Alexander, SCHOOL PSYCHOLOGIST
• Kaitlin Amrine, DPT
• Kathy Loy Buchanan, NP-C
• Takur George Buck, M.D.
• Lori Michelle Campas, LMSW
• Elvina Jean Charley, ED.S.
• Jennifer Elizabeth Charley, LCSW

• Family Nurse Practitioner in Ganado, AZ
• Providers in Ganado, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2022; 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.