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NPI Code Detail

MEDICARE: STACY BLANKENSHIP ARNP

MEDICARE: STACY BLANKENSHIP ARNP
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
1363LC1500XCommunity Health Nurse Practitioner45204KS

General Provider Information

NPI Number : 1972716405
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACY BLANKENSHIP ARNP
Provider Business Mailing Address
First Line : 5306 S MOSLEY ST
Second Line :
City : WICHITA
State : KS
Zip : 67216-3651
Country : US
Telephone Number : 316-524-7830
Fax Number :
Provider Business Practice Location Address
First Line : 2716 W CENTRAL AVE
Second Line :
City : WICHITA
State : KS
Zip : 67203-4904
Country : US
Telephone Number : 316-660-7394
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2007
Last Update Date : 07/08/2007

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