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General NPI Number Information
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NPI Number | 1952496408
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Entity Type | Individual
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Provider Name | ANITA MARIE BLATNIK APN
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Gender | Female
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 09/04/2012
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Provider Practice Location Address
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Address Line | UT STUDENT HEALTH CTR 1800 VOLUNTEER BLVD
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City | KNOXVILLE
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State | TN
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Zip | 37996-0001
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Country | US
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Telephone | 865-974-5066
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Fax | 865-974-5205
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Provider Business Mailing Address
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Address Line | 239 WILSON AVE
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City | MARYVILLE
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State | TN
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Zip | 37804
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Country | US
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Telephone | 865-983-5266
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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 | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | RN97696
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | APN6871
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License Number State | TN
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