David Lee Blank, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

0001300 Issued in CO

Practice address

909 Park St
Trinidad, CO 81082-2312

Phone

(303) 550-0888

NPI assigned

Apr 25, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472515200000",
    "number": "1487873337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 PARK ST",
            "city": "TRINIDAD",
            "state": "CO",
            "postal_code": "810822312",
            "telephone_number": "303-550-0888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 PARK ST",
            "city": "TRINIDAD",
            "state": "CO",
            "postal_code": "810822312",
            "telephone_number": "303-550-0888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANK",
        "first_name": "DAVID",
        "middle_name": "LEE",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-25",
        "last_updated": "2016-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "RN 77277",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CO",
            "license": "0001300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "24927244",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jerrie Dawn Bennett
• Kristy Kay Bennett, D.C.
• Jenna Benson, PTA
• Daniel Howard Berry, DDS
• Jeremy Scott Berry, PTA
• Steven David Blohm, DDS
• Valerie Jean Borsa, M.D.
• Marci Lee Bowers, MD
• Brian Scott DDS Ms PC
• Brick City Aesthetics LLC

• Certified Registered Nurse Anesthetist in Trinidad, CO
• Providers in Trinidad, CO by specialty
• Certified Registered Nurse Anesthetist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.