Provider Demographics
NPI:1255622791
Name:BLANKENSHIP, TAMMY MICHELE HEATH (NP)
Entity type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:MICHELE HEATH
Last Name:BLANKENSHIP
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:2699 WOLF CREEK RD
Mailing Address - Street 2:
Mailing Address - City:NARROWS
Mailing Address - State:VA
Mailing Address - Zip Code:24124-2637
Mailing Address - Country:US
Mailing Address - Phone:540-599-6372
Mailing Address - Fax:
Practice Address - Street 1:1906 BELLEVIEW AVE SE
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24014-1838
Practice Address - Country:US
Practice Address - Phone:540-981-7595
Practice Address - Fax:540-981-8857
Is Sole Proprietor?:No
Enumeration Date:2011-05-02
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0024169327363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily