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General NPI Number Information
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NPI Number | 1750601027
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Entity Type | Organization
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Legal Business Name | BLAND FAMILY CLINIC PLLC
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Dates
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Enumeration Date | 06/09/2010
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Last Update Date | 07/08/2010
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Provider Practice Location Address
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Address Line | 8494 S SCENIC HWY SUITE C&D
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City | BLAND
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State | VA
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Zip | 24315-5255
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Country | US
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Telephone | 276-688-0500
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Fax | 276-688-3200
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Provider Business Mailing Address
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Address Line | 8494 S SCENIC HWY SUITE C&D
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City | BLAND
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State | VA
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Zip | 24315-5255
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Country | US
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Telephone | 276-688-0500
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Fax | 276-688-3200
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Authorized Official
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Title or Position | OWNER
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Name | PATRICIA H MITCHELL
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Credential | NP
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Telephone | 276-688-4666
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024075081
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License Number State | VA
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