Provider Demographics
NPI:1427362219
Name:BLANKENSHIP, OLIVIA YVETTE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:OLIVIA
Middle Name:YVETTE
Last Name:BLANKENSHIP
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3101 HIGHWAY 71 E
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BASTROP
Mailing Address - State:TX
Mailing Address - Zip Code:78602-5156
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3101 HIGHWAY 71 E
Practice Address - Street 2:SUITE 101
Practice Address - City:BASTROP
Practice Address - State:TX
Practice Address - Zip Code:78602-5156
Practice Address - Country:US
Practice Address - Phone:512-304-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-04
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX705637363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily