Individual
KEVIN L. BLANCHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3000 SAINT MATTHEWS RD, ORANGEBURG, SC 29118-1442
(803) 395-2200
Mailing address
PO BOX 1245, ORANGEBURG, SC 29116-1245
(803) 395-4497
(803) 536-0998
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1357
SC
367500000X
Certified Registered Nurse Anesthetist
RN181838
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
507903223B
—
GA
05
—
507903223D
—
GA
05
—
GP2825
—
SC
Enumeration date
04/14/2006
Last updated
02/02/2011
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