Provider Demographics
NPI:1073323184
Name:BLANKENSHIP ANESTHESIA LLC
Entity type:Organization
Organization Name:BLANKENSHIP ANESTHESIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:BLANKENSHIP
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:443-572-5967
Mailing Address - Street 1:473 CARDIFF CT
Mailing Address - Street 2:
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-1617
Mailing Address - Country:US
Mailing Address - Phone:443-572-5967
Mailing Address - Fax:
Practice Address - Street 1:1304 BELLONA AVE
Practice Address - Street 2:
Practice Address - City:TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-5425
Practice Address - Country:US
Practice Address - Phone:443-572-5967
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-10
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty