Individual provider · Type 1 NPI

Kristin Blankenship, PA

Surgical Physician Assistant · Springfield, IL

NPI number 1174634562 Active

Practice location

747 N Rutledge St, 3rd Floor
Springfield, IL 62702-6700

Call (217) 545-8000 Map

Fax (217) 545-2588

Mailing address

PO Box 19653
Springfield, IL 62794-9653

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X085004979 (IL)

Surgical Physician Assistant: Definition to come...

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About NPI 1174634562

Kristin Blankenship, PA's National Provider Identifier is 1174634562, issued on Aug 31, 2006. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Springfield, IL. The record was last updated on Nov 17, 2014.