Basic Information
| Provider Information | |||||||||
| NPI: | 1982010898 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BLANCHARD | ||||||||
| FirstName: | COLLEEN | ||||||||
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| Credential: | CNP, APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 300 CARSON STREET | ||||||||
| Address2: | CLOPTON CLINIC OF JONESBORO, INC. | ||||||||
| City: | JONESBORO | ||||||||
| State: | AR | ||||||||
| PostalCode: | 72401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8709321198 | ||||||||
| FaxNumber: | 8709107709 | ||||||||
| Practice Location | |||||||||
| Address1: | 201 EAST OAK AVE ARRHYTHMIA ASSOCIATES OF NEA | ||||||||
| Address2: | SUITE B | ||||||||
| City: | JONESBORO | ||||||||
| State: | AR | ||||||||
| PostalCode: | 72401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8709380505 | ||||||||
| FaxNumber: | 8887421466 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2014 | ||||||||
| LastUpdateDate: | 06/28/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | A004164 | AR | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.