Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Stawa Rajab Blanco

Individual provider Family Nurse Practitioner · NPI 1073126314

Stawa Rajab Blanco is a Nurse Practitioner in Cincinnati, Ohio. Qualified in 2019, 7 years ago. Practices with Dedicated Ohio Holding LLC, a 7-clinician group and accepts Medicare assignment. Licensed in Kentucky, Ohio and West Virginia.

Years since qualifying
7
Licensed in
KY, OH, WV
In the registry since
2020
Specialties on file
3
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Practice location Address checks out

6121 Colerain Ave
Cincinnati, OH 45239-6417
Phone: (513) 354-2466
Fax: (513) 906-5477
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 0026867 (OH)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 30144773 (KY)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 110700 (WV)

Record details

NPI number1073126314
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedAugust 26, 2020
Last updated in NPPESDecember 1, 2022
Certification dateDecember 1, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Dedicated Ohio Holding Llc — 7 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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