Individual
JESSICA L BLANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3535 PENTAGON BLVD, BEAVERCREEK, OH 45431-1705
(937) 395-6665
Mailing address
PO BOX 638685, CINCINNATI, OH 45263-5283
(877) 882-5644
(866) 643-8146
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4007154
KY
363LA2100X
Acute Care Nurse Practitioner
Primary
APRN.CNP.0038855
OH
Other
Enumeration date
09/06/2023
Last updated
04/30/2025
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