| Doctor Name: | ERIN FAVRE BLANCHETTE |
| NPI Number: | 1912265943 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CPNP |
| License Number: | R870090 |
| Business Practice Address: | 618 Blue Meadow Rd Children's International Medical Group Bay St Louis, MS - 395202834 |
| Business Phone Number: | 2284671320 |
| Business Fax Number: | |
| Mailing Address: | 618 Blue Meadow Rd, BAY ST LOUIS |
| State: | MS |
| Postal Code: | 395202834 |
| Phone Number: | 2284671320 |
| Fax Number: | |
| NPI Enumeration Date: | 04/27/2012 |
| NPI Last Update Date: | 02/19/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | R870090 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |