National Provider Identifier Database

MARK N BLANKE, CRNP – NPI #1063083582
Pediatrics


Contact Information

MARK N BLANKE, CRNP
3400 CIVIC CENTER BLVD
PHILADELPHIA, PA19104-5127
Phone: 215-590-1000
Fax:
Website:
Specialty Taxonomy Code
* Pediatrics 363LP0200X

* Indicates primary specialty

NPI Profile & details for MARK N BLANKE

NPI Number 1063083582
Credentials CRNP (Certified Registered Nurse Practitioner)
Entity Individual
Enumeration date 07/06/2021
Last updated 07/06/2021 - About 5 years ago
Sole proprietor1 Yes
Identifiers
  • PA License #: SP023534
  • PA Other: SP023534 CERTIFIED REGISTERED NURSE PRACTITIONER - PENNSYLVANIA STATE BOARD OF NURSING
  • PA Other: NPPA045761 PRESCRIPTIVE AUTHORITY - PENNSYLVANIA STATE BOARD OF NURSING
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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