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General NPI Number Information
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NPI Number | 1134368087
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Entity Type | Individual
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Provider Name | TAWNY N BLANKINSHIP PA-C
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Gender | Female
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Dates
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Enumeration Date | 02/17/2009
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Last Update Date | 10/17/2011
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Provider Practice Location Address
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Address Line | 4112 E COMMERCE WAY
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City | SACRAMENTO
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State | CA
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Zip | 95834-9680
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Country | US
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Telephone | 916-447-6337
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Fax | 916-283-9939
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Provider Business Mailing Address
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Address Line | 4156 MANZANITA AVE
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City | CARMICHAEL
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State | CA
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Zip | 95608-1496
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Country | US
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Telephone | 530-559-4070
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA20189
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License Number State | CA
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