DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: MR. BLAINE CHRISTOPHER VAN AUSDELN FNP-C, M.S.

MEDICARE: MR. BLAINE CHRISTOPHER VAN AUSDELN FNP-C, M.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner326768/4523CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1RN326768OTHERCAMEDICAL PROVIDER ID

General Provider Information

NPI Number : 1194720144
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BLAINE CHRISTOPHER VAN AUSDELN FNP-C, M.S.
Provider Business Mailing Address
First Line : 7373 WEST LN
Second Line :
City : STOCKTON
State : CA
Zip : 95210-3377
Country : US
Telephone Number : 209-476-3569
Fax Number : 209-476-3675
Provider Business Practice Location Address
First Line : 7373 WEST LN
Second Line :
City : STOCKTON
State : CA
Zip : 95210-3377
Country : US
Telephone Number : 209-476-3569
Fax Number : 209-476-3675
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2005
Last Update Date : 07/09/2007

Similar Medicare Providers

1174520480 — BONNIE JANE MARTIN FNP
Practice Location Address:
7373 WEST LN
STOCKTON, CA
95210-3377
Practice Phone: 209-476-3928
Practice Fax: 209-476-3675
1427059849 — MRS. LINDA HURST FNP
Practice Location Address:
7373 WEST LANE
STOCKTON, CA
95210-3377
Practice Phone: 209-476-3405
Practice Fax:
1881687465 — REED GRANT MELLOR MD
Practice Location Address:
7373 WEST LN
STOCKTON, CA
95210-3377
Practice Phone: 209-476-3094
Practice Fax:
1497742027 — HONG LI MD
Practice Location Address:
7373 WEST LN
STOCKTON, CA
95210-3377
Practice Phone: 209-476-5989
Practice Fax:
1174514822 — MS. PAMELA JEAN DIAS NURSE PRACTITIONER
Practice Location Address:
7373 WEST LN
STOCKTON, CA
95210-3377
Practice Phone: 209-476-5405
Practice Fax: 209-476-3708
1194706770 — MISS MARIA DANETTE INFANTE LOPEZ RNP
Practice Location Address:
7373 WEST LN
STOCKTON, CA
95210-3377
Practice Phone: 209-476-5947
Practice Fax:

Directions to “ MR. BLAINE CHRISTOPHER VAN AUSDELN FNP-C, M.S.” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.