Individual
MRS. DANA L BLANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN,CPNP
Contact information
Practice address
201 QUINCY STREET, BROCKTON, MA 02302
(508) 584-1890
(508) 580-3332
Mailing address
201 QUINCY STREET, BROCKTON, MA 02302
(508) 584-1890
(508) 580-3332
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
216049
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NP9964
BCBSMA
MA
Enumeration date
05/03/2007
Last updated
07/08/2007
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