Provider Demographics
NPI:1871192971
Name:BLANKENSHIP, AMBER MAE
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:MAE
Last Name:BLANKENSHIP
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:PO BOX 106
Mailing Address - Street 2:
Mailing Address - City:OCEANA
Mailing Address - State:WV
Mailing Address - Zip Code:24870-0106
Mailing Address - Country:US
Mailing Address - Phone:304-800-5445
Mailing Address - Fax:
Practice Address - Street 1:7 SHORTS CT
Practice Address - Street 2:
Practice Address - City:OCEANA
Practice Address - State:WV
Practice Address - Zip Code:24870
Practice Address - Country:US
Practice Address - Phone:304-800-5445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-20
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant