Provider Demographics
NPI:1720253016
Name:BLANKENSHIP, CHERYL R (LAC)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:R
Last Name:BLANKENSHIP
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5553 N CROATAN HWY
Mailing Address - Street 2:
Mailing Address - City:SOUTHERN SHORES
Mailing Address - State:NC
Mailing Address - Zip Code:27949-4117
Mailing Address - Country:US
Mailing Address - Phone:252-449-8122
Mailing Address - Fax:252-441-4080
Practice Address - Street 1:5553 N CROATAN HWY
Practice Address - Street 2:
Practice Address - City:SOUTHERN SHORES
Practice Address - State:NC
Practice Address - Zip Code:27949-4117
Practice Address - Country:US
Practice Address - Phone:252-449-8122
Practice Address - Fax:252-441-4080
Is Sole Proprietor?:No
Enumeration Date:2008-04-28
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC204171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist