Provider Demographics
NPI:1124577580
Name:BLANKINSHIP, BLAIRE (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:BLAIRE
Middle Name:
Last Name:BLANKINSHIP
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 603725
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-3725
Mailing Address - Country:US
Mailing Address - Phone:828-575-2625
Mailing Address - Fax:828-350-2174
Practice Address - Street 1:3201 N VAN BUREN ST STE 350
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73703-1814
Practice Address - Country:US
Practice Address - Phone:580-366-0844
Practice Address - Fax:580-297-5197
Is Sole Proprietor?:No
Enumeration Date:2016-09-27
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0106365363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX200677520AMedicaid
TX6B3927OtherMEDICARE PTAN