Provider Demographics
NPI:1972286995
Name:BLANKENSHIP, LORI (LPN)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:BLANKENSHIP
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 COASTAL LN
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-6761
Mailing Address - Country:US
Mailing Address - Phone:910-385-4791
Mailing Address - Fax:
Practice Address - Street 1:180 COASTAL LN
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-6761
Practice Address - Country:US
Practice Address - Phone:910-385-4791
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-08
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.091158.MEDS-IV164W00000X
NC91202164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse