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Individual

MRS. ERICA LEE BLANKENSHIP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN BM

Contact information

Practice address
119 GAS PLANT RD, DU QUOIN, IL 62832-3866
(618) 542-8702
Mailing address
PO BOX 155, CHRISTOPHER, IL 62822-0155
(618) 724-2436

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043084772
IL

Other

Enumeration date
07/27/2012
Last updated
07/27/2012
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