Individual
BRANDEN BLANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGNP
Contact information
Practice address
708 BENTLEY CT, TYLER, TX 75703-4621
(903) 780-1186
Mailing address
708 BENTLEY CT, TYLER, TX 75703-4621
(903) 780-1186
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
AP140112
TX
Other
Enumeration date
03/25/2019
Last updated
03/25/2019
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