Individual
KAITLYN RUTHANN BLANKENBECKLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
416 ROLLING DR, KINGSPORT, TN 37660-6767
(423) 502-3072
Mailing address
416 ROLLING DR, KINGSPORT, TN 37660-6767
(423) 502-3072
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
32782
TN
Other
Enumeration date
12/14/2022
Last updated
12/14/2022
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