Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 95007501 | CA |
NPI | 1225542509 |
---|---|
Provider Name | Sheryl Lynn Blankers |
First Address | Hayward, CA 94545-2997 |
Second Address | Palo Alto, CA 94304-1207 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/11/2017 |
Last Update Date | 26/11/2017 |