Individual
SHANNON BLANKENBECKLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP-C, PMHNP-BC
Contact information
Practice address
2909 MARKET ST, WILMINGTON, NC 28403-1221
(910) 795-2118
(910) 795-2318
Mailing address
611 LAVEEN WAY, WILMINGTON, NC 28412-2697
(910) 470-8496
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
BLAN-GIKLC9
NC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
5007563
NC
Other
Enumeration date
02/17/2015
Last updated
07/24/2022
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