MEDICARE: MS. KRISTEN K BLANDFORD NP-C

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
1	363LF0000X	Family Nurse Practitioner	0024175208	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5013634	OTHER	NC	NC BOARD OF NURSING
2	1257845	OTHER	VA	VA BOARD OF NURSING

General Provider Information

NPI Number	:	1972027373
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KRISTEN K BLANDFORD NP-C

Provider Business Mailing Address
First Line	:	3814 BUNCOMBE DR
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27407-7326
Country	:	US
Telephone Number	:	336-860-0981
Fax Number	:

Provider Business Practice Location Address
First Line	:	4002 ELTON WAY STE 104
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27406-8973
Country	:	US
Telephone Number	:	336-860-0981
Fax Number	:	336-907-4714

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2017
Last Update Date	:	04/18/2025

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