Provider Demographics
NPI:1922729581
Name:HARTLAND, JOHN BLANKENSHIP (RN)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:BLANKENSHIP
Last Name:HARTLAND
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3388 ISADOR AVE
Mailing Address - Street 2:
Mailing Address - City:KINGMAN
Mailing Address - State:AZ
Mailing Address - Zip Code:86401-6447
Mailing Address - Country:US
Mailing Address - Phone:928-530-8437
Mailing Address - Fax:
Practice Address - Street 1:3388 ISADOR AVE
Practice Address - Street 2:
Practice Address - City:KINGMAN
Practice Address - State:AZ
Practice Address - Zip Code:86401-6447
Practice Address - Country:US
Practice Address - Phone:928-530-8437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN207664163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health