Healthcare Provider Details

I. General information

NPI: 1396201976
Provider Name (Legal Business Name): NASHON L BLAND CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2019
Last Update Date: 02/03/2025
Certification Date: 02/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5855 BREMO RD STE 100
RICHMOND VA
23226-1926
US

IV. Provider business mailing address

5855 BREMO RD STE 100
RICHMOND VA
23226-1926
US

V. Phone/Fax

Practice location:
  • Phone: 804-288-6258
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number0024177381
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: