Individual
DR. LISA D BLANKENSHIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
DOGWOOD AVE, VAMC, MOUNTAIN HOME, TN 63684
(423) 926-1171
Mailing address
PO BOX 4000 (117), PM&RS, MOUNTAIN HOME, TN 37684
(423) 926-1171
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
200100642
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89129E9
—
NC
Enumeration date
09/28/2006
Last updated
09/10/2010
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