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Individual

MADISON BLANKENSHIP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
320 EBAUGH ST, GLENWOOD, IA 51534-1811
(712) 527-5204
Mailing address
PO BOX 3755, OMAHA, NE 68103-0755
(402) 354-5451

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
149120
IA
363L00000X
Nurse Practitioner
Primary
A165688
IA

Other

Enumeration date
09/02/2021
Last updated
09/20/2021
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