Blaine, Jack Colt
Blaine, Jack Colt is an sole proprietor health care provider with primary practice located at 6709 Academy Rd Ne Ste A , Albuquerque NM 87109-3363. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Blaine, Jack Colt can be contacted via phone (505) 312-4712.Contact Information
Primary practice address
6709 Academy Rd Ne Ste A
Albuquerque NM 87109-3363
Phone: (505) 312-4712
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered | 367500000X | CRNA0061 | Arizona |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered | 367500000X | AP108435 | Texas |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered | 367500000X | NA1771 | California |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered | 367500000X | CRNA00868 | New Mexico |
Profile Details
| NPI number | 1811999642 |
|---|---|
| LBN Legal business name | Blaine, Jack Colt |
| Credentials | Certified Registered Nurse Anesthetist (CRNA) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 11th, 2005 |
| Last updated | Jan 19th, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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