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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

JOHN MICHAEL BLANCO MATA, NP

Active Sole Proprietor

JOHN MICHAEL BLANCO MATA, NP is a Nurse Practitioner healthcare provider located in PRESCOTT, Arizona. NPI 1639871247 is currently active in the NPPES registry. Verify at CMS.

Nurse Practitioner · PRESCOTT, AZ

Registration Details

NPI Number
1639871247
Provider Type
Individual
Gender
Male
NPI Issued
Mar 20, 2023 (3.4233856199995 yrs)
Last Updated
Jan 31, 2024
Licenses
267971 (AZ)
267971 (AZ)
267971 (AZ)
267971 (AZ)
267971 (AZ)
Sole Proprietor
Yes

Practice Information

Address
3250 GATEWAY BLVD STE 112
PRESCOTT, AZ, 863036856
Browse AZ providers · Browse ZIP 86303
Phone
7082480049
Primary Specialty
Nurse Practitioner
363L00000X
Additional Specialty
Nurse Practitioner

Other Nurse Practitioner Providers in PRESCOTT, AZ

Name Credential NPI
ANNE M BENSON FNPC 1487780482
KAREN RENE BUNTIN F.N.P. 1568582591
KIMBERLY CARLSON STOVER NP-C 1285817122
JAMES DEREK CALHOUN APRN 1245542331
ROBYN CLOW FNP-C 1306186572
LAUREN KATHERINE MILLS AGACNP 1376921023
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.