Provider Demographics
NPI:1477888931
Name:BLANKENSHIP, TERRY LEE (HCHI,HCD,CMT,CD(DONA)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:LEE
Last Name:BLANKENSHIP
Suffix:
Gender:F
Credentials:HCHI,HCD,CMT,CD(DONA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 S KITLEY AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-6711
Mailing Address - Country:US
Mailing Address - Phone:317-414-4095
Mailing Address - Fax:
Practice Address - Street 1:6512 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-6633
Practice Address - Country:US
Practice Address - Phone:317-322-1300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-16
Last Update Date:2009-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN374J00000X374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula