Individual
KOLLEEN F BLANKENSHIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3200 BURNET AVE, CINCINNATI, OH 45229-3019
(513) 475-8787
(513) 929-7239
Mailing address
1930 PRIME CT STE 105, TROY, OH 45373-9045
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
50.006103
OH
363AS0400X
Surgical Physician Assistant
Primary
50.006103RX
OH
Other
Enumeration date
08/21/2019
Last updated
05/18/2021
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