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NPI Code Detail

MEDICARE: DR. LARRY NATHANIEL BLANKENSHIP AUD

MEDICARE: DR. LARRY NATHANIEL BLANKENSHIP AUD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1231H00000XAudiologist23002915AIN

General Provider Information

NPI Number : 1427944743
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LARRY NATHANIEL BLANKENSHIP AUD
Provider Business Mailing Address
First Line : 1401 E 360 N
Second Line :
City : ANDERSON
State : IN
Zip : 46012-9611
Country : US
Telephone Number : 765-639-2956
Fax Number :
Provider Business Practice Location Address
First Line : 7926 W JEFFERSON BLVD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46804-4140
Country : US
Telephone Number : 260-469-6919
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2025
Last Update Date : 06/13/2025

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