Roberta F Blasenak, RN, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

4072466 Issued in TN

Practice address

801 Middle Creek Rd
Sevierville, TN 37862-5018

Phone

(865) 453-4434

Fax

(865) 428-3508

NPI assigned

Aug 23, 2006

Last updated

Jul 8, 2007By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Pediatric Nurse Practitioner, Registered Nurse

State licenses

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700993201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4559 WHETSTONE RD",
            "city": "SEVIERVILLE",
            "state": "TN",
            "postal_code": "378628195",
            "telephone_number": "865-774-6471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 MIDDLE CREEK RD",
            "city": "SEVIERVILLE",
            "state": "TN",
            "postal_code": "378625018",
            "telephone_number": "865-453-4434",
            "fax_number": "865-428-3508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLASENAK",
        "first_name": "ROBERTA",
        "middle_name": "F",
        "name_prefix": "Mrs.",
        "credential": "RN, CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TN",
            "license": "4072466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clyde Emmitt Blair, D.M.D.
• Melissa Renea Blair, FNP-BC
• Maria Blalock
• Cassidee Blankenship
• Kayla Blankenship
• BLC Wellington - Sevierville, LLC (Brookdale Sevierville)
• Mackenzie Elizabeth Bleazard
• Dana Nicole Bobeck, PHARM.D
• Randy Scott Boggs
• Luke Bolin

• Pediatric Nurse Practitioner in Sevierville, TN
• Providers in Sevierville, TN by specialty
• Pediatric Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.