Van Ausdeln, Blaine Christopher

Van Ausdeln, Blaine Christopher is an individual health care provider with primary practice located at 7373 West Ln , Stockton CA 95210-3377. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Van Ausdeln, Blaine Christopher can be contacted via phone (209) 476-3569.

Contact Information

Primary practice address
7373 West Ln Stockton CA 95210-3377
Phone: (209) 476-3569
Fax: (209) 476-3675
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 326768/4523 California

Profile Details

NPI number 1194720144
LBN Legal business name Van Ausdeln, Blaine Christopher
Credentials FNP-C, M.S.
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2005
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194720144 NPPES
California Other RN326768 MEDICAL PROVIDER ID

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