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NPI Code Detail

MEDICARE: MS. KRISTEN K BLANDFORD NP-C

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
1363LF0000XFamily Nurse Practitioner0024175208VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15013634OTHERNCNC BOARD OF NURSING
21257845OTHERVAVA 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 : 6000 UPPER BRANDON PL
Second Line :
City : NORFOLK
State : VA
Zip : 23508-1137
Country : US
Telephone Number : 414-248-3139
Fax Number :
Provider Business Practice Location Address
First Line : 1721 ADMIRAL TAUSSIG BLVD
Second Line :
City : NORFOLK
State : VA
Zip : 23511-2802
Country : US
Telephone Number : 757-953-9000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2017
Last Update Date : 04/06/2026

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