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General NPI Number Information
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NPI Number | 1740908649
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Entity Type | Individual
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Provider Name | LAUREN JULIA BLANKENSHIP DNP, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/16/2022
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Last Update Date | 08/16/2022
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Provider Practice Location Address
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Address Line | 1132 N CHURCH ST STE 101
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City | GREENSBORO
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State | NC
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Zip | 27401-1040
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Country | US
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Telephone | 336-398-3988
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Fax |
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Provider Business Mailing Address
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Address Line | 10533 108TH ST
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City | LARGO
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State | FL
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Zip | 33778-4030
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Country | US
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Telephone | 321-432-2829
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 5016743
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN9444447
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License Number State | FL
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