MEDICARE: JENNIFER RACHELLE BLANKENSHIP CCC-SLP

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
1	235Z00000X	Speech-Language Pathologist	SP#2400	AR

General Provider Information

NPI Number	:	1467667840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER RACHELLE BLANKENSHIP CCC-SLP

Provider Business Mailing Address
First Line	:	531 SKYLINE DR
Second Line	:
City	:	HOT SPRINGS NATIONAL PARK
State	:	AR
Zip	:	71901-8348
Country	:	US
Telephone Number	:	870-500-6015
Fax Number	:

Provider Business Practice Location Address
First Line	:	531 SKYLINE DR
Second Line	:
City	:	HOT SPRINGS NATIONAL PARK
State	:	AR
Zip	:	71901-8348
Country	:	US
Telephone Number	:	870-500-6015
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2007
Last Update Date	:	02/02/2024

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Directions to “ JENNIFER RACHELLE BLANKENSHIP CCC-SLP” Practice Location

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