Individual provider Active NPI

Blanche Kimbeng Afolabi, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Hanover, PA
National Provider Identifier
1891053211
Registry record updated Jun 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
SP030413 Issued in PA
Practice address
120 Penn St
Hanover, PA 17331-1928
Phone
(717) 969-8400
NPI assigned
Apr 24, 2012
Last updated
Jun 4, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X L8-0010913 DE
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R199835 MD
Psychiatric/Mental Health Nurse Practitioner 363LP0808X SP030413 PA Primary

Addresses

Primary practice location

120 Penn St
Hanover, PA 17331-1928

Mailing address

120 Penn St
Hanover, PA 17331-1928
Phone (717) 969-8400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260617001537 PA Practitioner - Nurse Practitioner 0345712766 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Supportive Care of Pennsylvania LLCGroup PAC ID 0143521211, 91 clinicians

Practice addresses (Care Compare)

2109 Red Lion Rd
Philadelphia, PA 19115-1711
Phone (718) 298-4375

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
L8-0010913DEMDPsychiatric/Mental Health Nurse Practitioner
R199835MDMDPsychiatric/Mental Health Nurse Practitioner
SP030413PAMDPsychiatric/Mental Health Nurse Practitioner

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1335225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780531200000",
    "number": "1891053211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 PENN ST",
            "city": "HANOVER",
            "state": "PA",
            "postal_code": "173311928",
            "telephone_number": "717-969-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 PENN ST",
            "city": "HANOVER",
            "state": "PA",
            "postal_code": "173311928",
            "telephone_number": "717-969-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AFOLABI",
        "first_name": "BLANCHE",
        "middle_name": "KIMBENG",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-24",
        "last_updated": "2026-06-04",
        "certification_date": "2026-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "DE",
            "license": "L8-0010913",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R199835",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP030413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hanover, PA

Sources for this page

Verify at the official NPI Registry.