Individual
BRANDON D BLANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
100 15TH ST NW, NORTON, VA 24273-1616
(276) 679-9600
Mailing address
96 15TH ST NW, SUITE 104, NORTON, VA 24273-1620
(276) 679-8890
(276) 679-9740
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
073553
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942392287
—
VA
05
—
7100062940
—
KY
Enumeration date
09/28/2006
Last updated
01/20/2010
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