Individual
JACQUELYN R BLANDFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
325 W WALNUT ST STE 600, LEBANON, KY 40033-1378
(270) 699-9500
(270) 795-4015
Mailing address
325 W WALNUT ST STE 600, LEBANON, KY 40033-1378
(270) 699-9500
(270) 795-4015
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1150702
KY
363LF0000X
Family Nurse Practitioner
Primary
4028681
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16334812
CAQH
KY
Enumeration date
10/02/2024
Last updated
07/08/2026
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