Healthcare Provider Details

I. General information

NPI: 1750601027
Provider Name (Legal Business Name): BLAND FAMILY CLINIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2010
Last Update Date: 07/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8494 S SCENIC HWY SUITE C&D
BLAND VA
24315-5255
US

IV. Provider business mailing address

8494 S SCENIC HWY SUITE C&D
BLAND VA
24315-5255
US

V. Phone/Fax

Practice location:
  • Phone: 276-688-0500
  • Fax: 276-688-3200
Mailing address:
  • Phone: 276-688-0500
  • Fax: 276-688-3200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024075081
License Number StateVA

VIII. Authorized Official

Name: PATRICIA H MITCHELL
Title or Position: OWNER
Credential: NP
Phone: 276-688-4666