Individual
MARY BLANKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
11800 TECH RD, SUITE 240, SILVER SPRING, MD 20904-1987
(301) 754-7740
(301) 754-7743
Mailing address
11800 TECH RD, SUITE 240, SILVER SPRING, MD 20904-1987
(301) 754-7740
(301) 754-7743
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R098788
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R098788
LICENSE
MD
Enumeration date
04/11/2006
Last updated
11/01/2007
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