Individual
MRS. BETH Y BLANKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-BC
Contact information
Practice address
555 WASHINGTON SQUARE SHOPPING CTR, WASHINGTON, MO 63090-5343
(636) 390-1777
(636) 390-1778
Mailing address
555 WASHINGTON SQUARE SHOPPING CTR, WASHINGTON, MO 63090-5343
(636) 390-1777
(636) 390-1778
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041337230
IL
163W00000X
Registered Nurse
2002013536
MO
363LF0000X
Family Nurse Practitioner
Primary
2021051162
MO
Other
Enumeration date
03/18/2022
Last updated
05/17/2022
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