Provider Demographics
NPI:1548412851
Name:BLANTON, CHRISTIANE M (CNP)
Entity Type:Individual
Prefix:
First Name:CHRISTIANE
Middle Name:M
Last Name:BLANTON
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:CHRISTIANE
Other - Middle Name:MARIE
Other - Last Name:BLANTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CNP
Mailing Address - Street 1:4895 OLENTANGY RIVER RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-1184
Mailing Address - Country:US
Mailing Address - Phone:614-457-7732
Mailing Address - Fax:614-457-4346
Practice Address - Street 1:4895 OLENTANGY RIVER RD
Practice Address - Street 2:SUITE 100
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-1184
Practice Address - Country:US
Practice Address - Phone:614-457-7732
Practice Address - Fax:614-457-4346
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-17
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.10284363LF0000X
OHNP10284363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2953442Medicaid
OHH079274Medicare PIN