Individual
MS. KRISTA ANN BLANTON-GOGUEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
251 N BAYOU ST, MOBILE, AL 36603-5827
(251) 690-8894
(251) 544-2188
Mailing address
PO BOX 2867, MOBILE, AL 36652-2867
(251) 690-8894
(251) 544-2188
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-115682
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
213877
—
AL
Enumeration date
09/11/2009
Last updated
11/28/2018
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