Provider Demographics
NPI:1326481979
Name:BLANKENSHIP, JAMES ALLEN (C-APN)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ALLEN
Last Name:BLANKENSHIP
Suffix:
Gender:M
Credentials:C-APN
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 248
Mailing Address - Street 2:146 CCA RD
Mailing Address - City:LUMPKIN
Mailing Address - State:GA
Mailing Address - Zip Code:31815
Mailing Address - Country:US
Mailing Address - Phone:229-838-1270
Mailing Address - Fax:866-381-0255
Practice Address - Street 1:146 CCA ROAD
Practice Address - Street 2:
Practice Address - City:LUMPKIN
Practice Address - State:GA
Practice Address - Zip Code:31815
Practice Address - Country:US
Practice Address - Phone:229-838-1270
Practice Address - Fax:866-381-0255
Is Sole Proprietor?:No
Enumeration Date:2013-04-14
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001177356163W00000X
WV50624163WG0000X
VA0024165021363LF0000X
VA0017137421363LF0000X
VA1177356363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice