Individual
JACQUELYN R BLANDFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
101 WINSTON WAY, STE C&D, CAMPBELLSVILLE, KY 42718-4962
(270) 465-9400
(866) 887-5768
Mailing address
PO BOX 1080, BURKESVILLE, KY 42717-1080
(270) 858-6655
(270) 858-4027
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
10/27/2025
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