Doctor Name: | VALERIE LYNN BLATNIK |
NPI Number: | 1023199361 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | N.P |
License Number: | 5734 |
Business Practice Address: | 10006 Chimney Dr Waxhaw, NC - 281736898 |
Business Phone Number: | 7042563300 |
Business Fax Number: | |
Mailing Address: | 10006 Chimney Dr, WAXHAW |
State: | NC |
Postal Code: | 281736898 |
Phone Number: | 7042563300 |
Fax Number: | |
NPI Enumeration Date: | 10/17/2006 |
NPI Last Update Date: | 01/26/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LN0000X |
License Number: | 5734 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Neonatal |
Taxonomy Definition: |