Jennifer Blansett, CRNP | |
103 Centennial St Ste C, La Plata, MD 20646-5985 | |
(301) 934-9111 | |
(301) 934-9111 |
Full Name | Jennifer Blansett |
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Gender | Female |
Speciality | Pediatrics |
Location | 103 Centennial St Ste C, La Plata, Maryland |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1982219739 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | R198500 (Maryland) | Primary |
Entity Name | La Plata Pediatrics & Family Health, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1891001996 PECOS PAC ID: 8022207059 Enrollment ID: O20110106000662 |
Mailing Address | Practice Location Address |
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Jennifer Blansett, CRNP 103 Centennial St Ste C, La Plata, MD 20646-5985 Ph: (301) 934-9111 | Jennifer Blansett, CRNP 103 Centennial St Ste C, La Plata, MD 20646-5985 Ph: (301) 934-9111 |
Dr. Eugene Suwandhi, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 5 Garrett Ave, La Plata, MD 20646 Phone: 301-609-4539 | |
Lisa M Wiltrout, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 5 Garrett Ave, Civista Medical Center, La Plata, MD 20646 Phone: 301-609-4000 | |
Daniel Tummillo, M.D Pediatrics Medicare: Medicare Enrolled Practice Location: 5 Garrett Ave, La Plata, MD 20646 Phone: 301-609-4000 | |
Dr. James Joseph Vitek, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 701 East Charles Street, La Plata, MD 20646 Phone: 301-609-4000 Fax: 301-609-4311 |