Individual
MR. ADAM K BLANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
1225 N STATE ST, JACKSON, MS 39202-2064
(601) 968-1000
Mailing address
PO BOX 23090, JACKSON, MS 39225-3090
(866) 916-5259
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
860496
MS
Other
Enumeration date
07/29/2008
Last updated
02/08/2016
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