Provider Demographics
NPI:1811456189
Name:BLAND, KRISTEN TAYLOR (APRN)
Entity type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:TAYLOR
Last Name:BLAND
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1319 BLAKEMORE CT E
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32317-8459
Mailing Address - Country:US
Mailing Address - Phone:850-545-2306
Mailing Address - Fax:
Practice Address - Street 1:100 PLANTATION RD
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:FL
Practice Address - Zip Code:32348-6000
Practice Address - Country:US
Practice Address - Phone:850-584-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-17
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9316605363LF0000X
FLARNP9316605363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily