Brandie Dawn Blank, LVN

Individual provider Active NPI Licensed Vocational Nurse · Azle, TX

NPI 1154810075 · NPPES record last updated May 7, 2018

Key facts

NPI
1154810075
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Vocational Nurse 164X00000X
License
233978 (TX)
Practice address
525 Commerce St Apt 111
Azle, TX 76020-2467
Phone
(682) 218-9816
NPI assigned
May 7, 2018
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
233978TXMDLicensed Vocational Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 233978 TX Yes

Addresses

Primary practice location

525 Commerce St Apt 111
Azle, TX 76020-2467

Mailing address

525 Commerce St Apt 111
Azle, TX 76020-2467
Phone (682) 218-9816

Other providers in Azle, TX

All providers in Azle, TX · Licensed Vocational Nurse in Texas

Sources for this page

Verify at the official NPI Registry.