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General NPI Number Information
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NPI Number | 1427314616
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Entity Type | Individual
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Provider Name | ASHLEY L BLASKE M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/02/2012
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Last Update Date | 06/06/2024
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Provider Practice Location Address
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Address Line | 408 N STATE OF FRANKLIN RD STE 31A
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City | JOHNSON CITY
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State | TN
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Zip | 37604-6088
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Country | US
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Telephone | 423-431-4946
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Fax |
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Provider Business Mailing Address
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Address Line | 1021 W OAKLAND AVE STE 310
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City | JOHNSON CITY
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State | TN
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Zip | 37604-2192
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Country | US
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Telephone | 423-302-6565
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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 | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 54938
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 54938
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 2080P0216X
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Taxonomy Name | Pediatric Rheumatology Physician
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License Number | 54938
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License Number State | TN
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