| NPI | 1952021487 |
|---|---|
| Former Name | DUSTIN GENE BLANKENSHIP |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 9482) |
| Enumeration Date | 2022-09-02 |
| Last Update Date | 2022-09-02 |