Individual
DIANE BLANCHFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2001 VAIL AVE, CHARLOTTE, NC 28207-1219
(704) 304-6202
Mailing address
PO BOX 60499, CHARLOTTE, NC 28260-0499
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
40958
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8050906
—
NC
05
—
NAN741
—
SC
Enumeration date
06/12/2006
Last updated
06/03/2008
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