| Doctor Name: | MRS. ALICE MARIE BLANDFORD |
| NPI Number: | 1104851617 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | 1142282 |
| Business Practice Address: | 500 W Sagamore Ave Clewiston, FL - 334403514 |
| Business Phone Number: | 8639833434 |
| Business Fax Number: | 8639836655 |
| Mailing Address: | 333 W Aztec Ave, CLEWISTON |
| State: | FL |
| Postal Code: | 334404401 |
| Phone Number: | 8639833434 |
| Fax Number: | 8639836655 |
| NPI Enumeration Date: | 07/12/2006 |
| NPI Last Update Date: | 02/05/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 1142282 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |