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Individual

BETSY BLANK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
1737 CARRY PL, CROFTON, MD 21114-2324
(301) 751-3888
(301) 262-7383
Mailing address
PO BOX 465, LOTHIAN, MD 20711-0465
(301) 751-3888
(301) 262-7383

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R097929
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
53590002
CAREFIRST BCBS GHMS
DC
05
687602100
MD
Enumeration date
08/31/2005
Last updated
11/10/2010
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