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General NPI Number Information
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NPI Number | 1336778299
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Entity Type | Individual
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Provider Name | CHRISTOPHER BLAISDELL CRNP-BC
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Gender | Male
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Dates
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Enumeration Date | 04/03/2020
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Last Update Date | 04/03/2020
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Provider Practice Location Address
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Address Line | 525 E 68TH ST
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City | NEW YORK
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State | NY
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Zip | 10065-4870
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Country | US
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Telephone | 256-599-2058
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Fax |
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Provider Business Mailing Address
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Address Line | 116 KINGSTON CT
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City | BIRMINGHAM
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State | AL
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Zip | 35211-7900
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Country | US
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Telephone | 256-599-2058
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LN0000X
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Taxonomy Name | Neonatal Nurse Practitioner
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License Number | 1-153810
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License Number State | AL
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