Individual
ANGELA ALLEN-BLAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1901 E FRANKLIN ST STE 108, RICHMOND, VA 23223-6966
(617) 379-0496
(617) 379-0434
Mailing address
PO BOX 159, LAWRENCEVILLE, VA 23868-0159
(434) 917-0970
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001204274
VA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0024175587
VA
Other
Enumeration date
10/25/2017
Last updated
05/30/2023
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