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Mr. Blaine Christopher Van Ausdeln, FNP-C,MS
Family Nurse Practitioner in Stockton, California
NPI 1194720144

Blaine Christopher Van Ausdeln is a Family Nurse Practitioner based in Stockton, CA and is specialized in Family. Blaine Christopher Van Ausdeln practices in Stockton, CA and has the professional credentials of FNP-C,MS. The NPI Number for Blaine Christopher Van Ausdeln is 1194720144 and holds a License No. 326768/4523 (California).

The current practice location address for Blaine Christopher Van Ausdeln is 7373 West Ln, Stockton, CA and can be reached out via phone at 209-476-3569 and via fax at 209-476-3675.

Location: 7373 West Ln, Stockton, CA, 95210-3377
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Provider Profile Details
NPI Number
1194720144
Provider Name
Blaine Christopher Van Ausdeln
Credential
FNP-C,MS
Provider Entity Type
Individual
Gender
Male
Address
7373 West Ln, Stockton, CA, 95210-3377
Phone Number
209-476-3569
Fax Number
209-476-3675
Provider Enumeration Date
06/16/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
RN326768 01 CA MEDICAL PROVIDER ID
institution
Provider Business Practice Location Address Details
Address
7373 West Ln
City
State
Zip
95210-3377
Phone Number
209-476-3569
Fax Number
209-476-3675
person
Provider Business Mailing Address Details
Address
7373 West Ln
City
State
Zip
95210-3377
Phone Number
209-476-3569
Fax Number
209-476-3675
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
326768/4523 (California)
Definition
Definition to come...
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