Healthcare Provider Details

I. General information

NPI: 1366364176
Provider Name (Legal Business Name): CASEY BLANKENSHIP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6401 POLO CLUB LN
LEXINGTON KY
40509-8561
US

IV. Provider business mailing address

806 HEADSTALL RD
NICHOLASVILLE KY
40356-6642
US

V. Phone/Fax

Practice location:
  • Phone: 859-294-0510
  • Fax:
Mailing address:
  • Phone: 423-381-1488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number025869
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: