Provider Demographics
NPI:1063735744
Name:AUGUSTIN, BLANDINE (FNP)
Entity type:Individual
Prefix:MRS
First Name:BLANDINE
Middle Name:
Last Name:AUGUSTIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8350 RICHMOND HWY STE 301
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22309-2344
Mailing Address - Country:US
Mailing Address - Phone:703-981-0708
Mailing Address - Fax:
Practice Address - Street 1:8350 RICHMOND HWY STE 301
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22309-2344
Practice Address - Country:US
Practice Address - Phone:703-768-7044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-09
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC000738363LF0000X
VA0024169332363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily