Individual
BRANDI L BLANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
1323 E MANSFIELD ST, BUCYRUS, OH 44820-1960
(419) 563-0300
(419) 563-0500
Mailing address
700 N COLUMBUS ST, CRESTLINE, OH 44827-1455
(419) 468-0522
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN.CNP.16051
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0113714
—
OH
Enumeration date
11/12/2014
Last updated
12/28/2020
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