Individual
MARY REBECCA BLANKENSHIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
837 BATTLE ST E, TALLADEGA, AL 35160-2670
(256) 649-8134
Mailing address
1500 1ST AVE N, BIRMINGHAM, AL 35203-1865
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-101322
AL
Other
Enumeration date
07/03/2017
Last updated
07/03/2017
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