Individual provider · Type 1 NPI
Blaine Christopher Van Ausdeln, FNP-C, M.S.
Family Nurse Practitioner · Stockton, CA
NPI number
1194720144
Active
Practice location
7373 West Ln
Stockton, CA 95210-3377
Fax (209) 476-3675
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | 326768/4523 (CA) |
Family Nurse Practitioner: Definition to come...
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About NPI 1194720144
Blaine Christopher Van Ausdeln, FNP-C, M.S.'s National Provider Identifier is 1194720144, issued on Jun 16, 2005. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Stockton, CA. The record was last updated on Jul 9, 2007.