Individual
REBECCA JEANNINE BLAKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
350 HOSPITAL WAY STE 100, SOMERSET, KY 42503-1872
(865) 207-3466
Mailing address
350 HOSPITAL WAY STE 100, SOMERSET, KY 42503-1872
(606) 451-2756
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
23410
TN
208000000X
Pediatrics Physician
Primary
3014537
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23410
ADVANCED PRACTICE REGISTERED NURSE
TN
Enumeration date
10/20/2017
Last updated
11/14/2020
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