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NPI Code Detail

MEDICARE: SHAWNA M BLANKENSHIP

MEDICARE: SHAWNA M BLANKENSHIP
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1932744794
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAWNA M BLANKENSHIP
Provider Business Mailing Address
First Line : 6311 GARNERS FERRY RD
Second Line :
City : COLUMBIA
State : SC
Zip : 29209-1445
Country : US
Telephone Number : 803-216-3300
Fax Number :
Provider Business Practice Location Address
First Line : 6311 GARNERS FERRY RD
Second Line :
City : COLUMBIA
State : SC
Zip : 29209-1445
Country : US
Telephone Number : 803-216-3300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2019
Last Update Date : 08/28/2020

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Directions to “ SHAWNA M BLANKENSHIP ” Practice Location

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