Individual
JACQUELINE D. BLANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
1801 N WASHINGTON ST, STE. 300, TULLAHOMA, TN 37388-8245
(931) 393-4995
(931) 393-3573
Mailing address
1801 N WASHINGTON ST, STE. 300, TULLAHOMA, TN 37388-8245
(931) 393-4995
(931) 393-3573
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
13405
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3341754
—
TN
Enumeration date
03/19/2008
Last updated
10/29/2013
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