Provider Demographics
NPI:1568680619
Name:BLANKENSHIP, RHODA
Entity Type:Individual
Prefix:MS
First Name:RHODA
Middle Name:
Last Name:BLANKENSHIP
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:RHODA
Other - Middle Name:LYNN
Other - Last Name:BLANKENSHIP
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:614 TULLY RD
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95111-1048
Mailing Address - Country:US
Mailing Address - Phone:408-494-1507
Mailing Address - Fax:408-494-1557
Practice Address - Street 1:614 TULLY RD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95111-1048
Practice Address - Country:US
Practice Address - Phone:408-494-1507
Practice Address - Fax:408-494-1557
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA532240163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse