Individual
KRISTEN H BLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
743 SPRING ST NE, GAINESVILLE, GA 30501-3715
(770) 534-2020
(770) 534-8025
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
RN170221
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN170221
GA MEDICAL NP LICENSE
GA
Enumeration date
07/03/2012
Last updated
09/27/2022
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