person
Kristin Blankenship, PA
Surgical Physician Assistant in Springfield, Illinois
NPI 1174634562

Kristin Blankenship is a Surgical Physician Assistant based in Springfield, IL and is specialized in Surgical. Kristin Blankenship practices in Springfield, IL and has the professional credentials of PA. The NPI Number for Kristin Blankenship is 1174634562 and holds a License No. 085004979 (Illinois).

The current practice location address for Kristin Blankenship is 747 N Rutledge St, Springfield, IL and can be reached out via phone at 217-545-8000 and via fax at 217-545-2588.

Location: 747 N Rutledge St, Springfield, IL, 62794-9653
person
Provider Profile Details
NPI Number
1174634562
Provider Name
Kristin Blankenship
Credential
PA
Provider Entity Type
Individual
Gender
Female
Address
747 N Rutledge St, Springfield, IL, 62794-9653
Phone Number
217-545-8000
Fax Number
217-545-2588
Provider Enumeration Date
08/31/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
P00653958 01 RAILROAD MEDICARE
431560263 01 TRICARE WEST
institution
Provider Business Practice Location Address Details
Address
747 N Rutledge St
City
State
Zip
62702-6700
Phone Number
217-545-8000
Fax Number
217-545-2588
person
Provider Business Mailing Address Details
Address
747 N Rutledge St
City
State
Zip
62702-6700
Phone Number
217-545-8000
Fax Number
217-545-2588
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
License No.
085004979 (Illinois)
Definition
Definition to come...
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