Individual
KYLE STEVEN BLANKENSHIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
516 E NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 722-1000
Mailing address
1101 DOWNS BLVD APT B107, FRANKLIN, TN 37064-3853
(317) 209-5459
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
213829
TN
Other
Enumeration date
03/24/2020
Last updated
03/24/2020
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