Individual
CHRISTINA PACILEO BLOTTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1250 E MARSHALL ST, SURGERY, RICHMOND, VA 23298-5051
(804) 828-3033
(804) 828-3045
Mailing address
PO BOX 91734, RICHMOND, VA 23291-1734
(804) 828-3033
(804) 828-3045
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024167023
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C05700
GROUP PTAN
VA
Enumeration date
09/16/2006
Last updated
03/18/2013
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