Bethany Leigh Blonde, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP7464 Issued in AZ

Practice address

18591 N 59TH Ave
Glendale, AZ 85308

Phone

(480) 403-1416

NPI assigned

Nov 19, 2014

Last updated

Jun 3, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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)

Enrolled

Credentials

Nurse Practitioner

State licenses

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

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

{
    "created_epoch": "1416355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1720485717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18591 N 59TH AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853081251",
            "telephone_number": "480-403-1416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18591 N 59TH AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "85308",
            "telephone_number": "480-403-1416"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14672 N Frank Lloyd Wright Blvd",
            "address_2": "Minute Clinic",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852602043",
            "country_code": "US",
            "telephone_number": "866-389-2727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLONDE",
        "first_name": "BETHANY",
        "middle_name": "LEIGH",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-19",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP7464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blissful Living Home LLC
• Amber Block-Zambrano
• Andrea Block, PA-C
• Paul Michael Block, M.D.
• Nicole Blohm
• Andrea Hope Bloom
• Karri Lynn Bloom, PHARM. D
• Bloomcare PLLC
• Blooming Care Solutions LLC
• Blooming Care Solutions LLC

• Family Nurse Practitioner in Glendale, AZ
• Providers in Glendale, 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 Jun 3, 2021; 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.