Individual
KRISTEN DONALD BLAKENEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1200 N STATE ST STE 270, JACKSON, MS 39202-2027
(601) 614-6470
(601) 714-6471
Mailing address
965 RIDGE LAKE BLVD STE 315, MEMPHIS, TN 38120-9401
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
905328
MS
Other
Enumeration date
08/16/2022
Last updated
09/15/2022
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