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Individual

NICOLE BLANKENSHIP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1200 W CARY ST, RICHMOND, VA 23220-5410
(804) 359-9375
Mailing address
14300 SAPPHIRE PARK LN APT 302, MIDLOTHIAN, VA 23114-5324

Taxonomy

Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
0024178019
VA

Other

Enumeration date
09/28/2020
Last updated
09/28/2020
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