Individual
KRYSTI M BLANKENSHIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1102 W 32ND ST STE 200, JOPLIN, MO 64804-3503
(417) 347-5001
(417) 347-2477
Mailing address
PO BOX 3810, JOPLIN, MO 64803-3810
(417) 347-5001
(417) 347-2477
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
137978
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2000779010A
—
OK
05
—
200371410A
—
KS
01
—
206859
ANTHEM
MO
05
—
428336002
—
MO
01
—
P00309838
RR MEDICARE
—
Enumeration date
06/25/2006
Last updated
03/08/2012
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