Stephanie Ford Blache, MS, RN, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

501766 Issued in TX

Practice address

8515 Greenville Ave Ste N108
Dallas, TX 75243-7035

Phone

(214) 221-0855

Fax

(214) 221-1437

NPI assigned

Aug 31, 2006

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, Master of Science, Registered Nurse

State licenses

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591660800000",
    "number": "1811008592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7200 STATE HIGHWAY 161",
            "address_2": "SUITE 100",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750392804",
            "telephone_number": "972-331-7200",
            "fax_number": "972-331-7201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8515 GREENVILLE AVE STE N108",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752437035",
            "telephone_number": "214-221-0855",
            "fax_number": "214-221-1437"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7200 State Highway 161",
            "address_2": "SUITE 100",
            "address_purpose": "LOCATION",
            "city": "Irving",
            "state": "TX",
            "postal_code": "750392804",
            "country_code": "US",
            "telephone_number": "972-331-7200",
            "fax_number": "972-331-7201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACHE",
        "first_name": "STEPHANIE",
        "middle_name": "FORD",
        "credential": "MS, RN, CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-06-09",
        "certification_date": "2020-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "501766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raymond Richard Bixby, M.D.
• Ibienebo Nelly Biyi, PT
• James Eustace Bizzell II, M.D.
• Carol A Bjorkman, NP
• BK Neuromonitoring, PLLC
• Jon D Blachley, MD
• Agnes Blachut, RDN, LD
• Alisha Black
• Alyssa Black
• Brandon Black, OPA-C

• Pediatric Nurse Practitioner in Dallas, TX
• Providers in Dallas, TX by specialty
• Pediatric Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2020; 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.