| NPI | 1538185848 |
|---|---|
| Other Name | BRENDA MICHELLE THEILEN-BLANKENSHIP |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 135188) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 17635A) |
| 363L00000X Nurse Practitioner (Licence: GA RN229112) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2020-01-17 |