Individual
JENNIFER L. BLANKENSHIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHCNP
Contact information
Practice address
8224 PARK LN STE 130, VICKERY HEALTH CENTER, DALLAS, TX 75231-6021
(214) 266-0266
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
643191
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145299701
—
TX
05
—
145299702
—
TX
05
—
145299703
—
TX
05
—
145299704
—
TX
05
—
145299705
—
TX
05
—
145299706
—
TX
05
—
145299707
—
TX
05
—
145299708
—
TX
05
—
145299709
—
TX
05
—
145299710
—
TX
05
—
145299711
—
TX
01
—
8Y1540
BLUE CROSS BLUE SHIELD
TX
Enumeration date
12/28/2006
Last updated
05/13/2009
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