Individual
KRISTA BLAYLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
300 S PRESTON ST, RANSON, WV 25438-1631
(304) 728-1642
Mailing address
300 S PRESTON ST, RANSON, WV 25438-1631
(304) 728-1642
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001215789
VA
163W00000X
Registered Nurse
Primary
67049
WV
163W00000X
Registered Nurse
R177378
MD
Other
Enumeration date
07/27/2015
Last updated
07/27/2015
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