Provider Demographics
NPI:1871837070
Name:BLAYDON, ADRIENNE L (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:ADRIENNE
Middle Name:L
Last Name:BLAYDON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 PINE GROVE COMMONS
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-5178
Mailing Address - Country:US
Mailing Address - Phone:717-741-5959
Mailing Address - Fax:717-741-4395
Practice Address - Street 1:310 PINE GROVE COMMONS
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-5178
Practice Address - Country:US
Practice Address - Phone:717-741-5959
Practice Address - Fax:717-741-4395
Is Sole Proprietor?:No
Enumeration Date:2012-11-12
Last Update Date:2012-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP012462163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse