Provider Demographics
NPI:1639536618
Name:BLANKENSHIP, JAMES KELLEY (FNP-C)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:KELLEY
Last Name:BLANKENSHIP
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 DODSON ST
Mailing Address - Street 2:
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70563-1826
Mailing Address - Country:US
Mailing Address - Phone:337-251-1079
Mailing Address - Fax:
Practice Address - Street 1:3619 AMBASSADOR CAFFERY PKWY
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-5132
Practice Address - Country:US
Practice Address - Phone:337-534-4410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-21
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP08604363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily