Mata, John Michael Blanco

Mata, John Michael Blanco is an sole proprietor health care provider with primary practice located at 3250 Gateway Blvd Ste 112 , Prescott AZ 86303-6856. He recently has 5 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Acute Care, Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Critical Care Medicine, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Gerontology. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is his primary health care specialty. Mata, John Michael Blanco can be contacted via phone (708) 248-0049.

Contact Information

Primary practice address
3250 Gateway Blvd Ste 112 Prescott AZ 86303-6856
Phone: (708) 248-0049
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 267971 Arizona
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 267971 Arizona
Physician Assistants & Advanced Practice Nursing Providers / Critical Care Medicine 363LC0200X 267971 Arizona
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 267971 Arizona
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X 267971 Arizona

Profile Details

NPI number 1639871247
LBN Legal business name Mata, John Michael Blanco
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 20th, 2023
Last updated Jan 31st, 2024 - about 10 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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