Healthcare Provider Details

I. General information

NPI: 1386877967
Provider Name (Legal Business Name): JANICE MARIE BLANKENSHIP RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2009
Last Update Date: 08/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 DOWNS BLVD APT J104
FRANKLIN TN
37064-3867
US

IV. Provider business mailing address

1101 DOWNS BLVD APT J104
FRANKLIN TN
37064-3867
US

V. Phone/Fax

Practice location:
  • Phone: 615-595-4204
  • Fax: 615-595-4204
Mailing address:
  • Phone: 615-595-4204
  • Fax: 615-595-4204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN0000102612
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: