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General NPI Number Information
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NPI Number | 1457417230
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Entity Type | Individual
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Provider Name | JENNIFER L. BLANKENSHIP WHCNP
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Gender | Female
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Dates
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Enumeration Date | 12/28/2006
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Last Update Date | 05/13/2009
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Provider Practice Location Address
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Address Line | 8224 PARK LN STE 130 VICKERY HEALTH CENTER
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City | DALLAS
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State | TX
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Zip | 75231-6021
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Country | US
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Telephone | 214-266-0266
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 660599
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City | DALLAS
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State | TX
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Zip | 75266-0599
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Country | US
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Telephone |
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 643191
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License Number State | TX
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