Individual provider · Type 1 NPI
Roy L. Blanco, APRN, MSN, FNP-C, PA-C
Family Nurse Practitioner · Stockton, CA
NPI number
1417074907
Active
Practice location
7373 West Ln
Stockton, CA 95210-3377
Fax (916) 887-7920
Mailing address
5530 Vintage Cir
Stockton, CA 95219-2510
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant | 363A00000X | PA 19007 (CA) |
| Family Nurse Practitioner Primary | 363LF0000X | NP 16596 (CA) |
Family Nurse Practitioner: Definition to come...
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About NPI 1417074907
Roy L. Blanco, APRN, MSN, FNP-C, PA-C's National Provider Identifier is 1417074907, issued on Mar 22, 2007. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Stockton, CA. The record was last updated on Mar 15, 2022.