Provider Demographics
NPI:1326578972
Name:BLANKS, DAISHA
Entity Type:Individual
Prefix:
First Name:DAISHA
Middle Name:
Last Name:BLANKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:491 E 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:PA
Mailing Address - Zip Code:15120-1901
Mailing Address - Country:US
Mailing Address - Phone:412-464-2101
Mailing Address - Fax:412-464-2102
Practice Address - Street 1:491 E 8TH AVE
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:PA
Practice Address - Zip Code:15120-1901
Practice Address - Country:US
Practice Address - Phone:412-464-2101
Practice Address - Fax:412-464-2102
Is Sole Proprietor?:No
Enumeration Date:2017-06-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN296704164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse