Healthcare Provider Details

I. General information

NPI: 1285670216
Provider Name (Legal Business Name): TAMMY L BLANKENSHIP MD, MPH, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 08/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

960 LEARNING WAY
TALLAHASSEE FL
32306-4178
US

IV. Provider business mailing address

960 LEARNING WAY
TALLAHASSEE FL
32306-4178
US

V. Phone/Fax

Practice location:
  • Phone: 850-644-6230
  • Fax: 850-644-4251
Mailing address:
  • Phone: 850-644-6230
  • Fax: 850-644-4251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberME 70169
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: