Individual
MISTY LEANN BLANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 CARRERA DR, LONDON, KY 40741-6303
(606) 260-8962
Mailing address
PO BOX 102, BAXTER, KY 40806-0102
(606) 273-5261
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3017644
KY
Other
Enumeration date
04/25/2022
Last updated
07/14/2022
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