Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. JACK COLT BLAINE, CRNA
Active Sole ProprietorCertified Nurse Anesthetist (CRNA) · ALBUQUERQUE, NM
Registration Details
- NPI Number
- 1811999642
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 11, 2005 (20.693920607809 yrs)
- Last Updated
- Jan 19, 2022
- Licenses
-
CRNA0061 (AZ)AP108435 (TX)NA1771 (CA)CRNA00868 (NM)
- Sole Proprietor
- Yes
Practice Information
- Address
-
6709 ACADEMY RD NE STE AALBUQUERQUE, NM, 871093363Browse NM providers · Browse ZIP 87109
- Phone
- 5053124712
- Primary Specialty
-
Certified Nurse Anesthetist (CRNA)
367500000X
- Additional Specialty
- Certified Nurse Anesthetist (CRNA)
- Additional Specialty
- Certified Nurse Anesthetist (CRNA)
- Additional Specialty
- Certified Nurse Anesthetist (CRNA)
Other Certified Nurse Anesthetist (CRNA) Providers in ALBUQUERQUE, NM
| Name | Credential | NPI |
|---|---|---|
| DAVID A CARLSON | CRNA | 1679575815 |
| PATRICIA A REDLIN | CRNA | 1295739530 |
| CATHERINE OBOJSKI | CRNA | 1447252606 |
| ROBERT C PAUL | CRNA | 1093717241 |
| DARLENE L BATSON | CRNA | 1295737542 |
| PAULINE C BROWN | CRNA | 1346242583 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.