Individual
JANNA BLANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
301 ANDREWS AVE., FORT RUCKER, AL 36362
(334) 255-7973
Mailing address
301 ANDREWS AVE., FORT RUCKER, AL 36362
(334) 255-7973
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2-063056
AL
Other
Enumeration date
12/10/2020
Last updated
12/10/2020
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