Most Relevant Information
Provider Data
| NPI Number: | 1003412404 |
| Provider Name: | JANNA BLANKS |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | 2-063056 |
Most Important Dates
| Enumeration Date: | 12/10/2020 |
| Last Updated: | 12/10/2020 |
Provider Practice Location
301 ANDREWS AVE.
FORT RUCKER
AL
36362
Practice Location Phone/Fax
| Phone: | 3342557973 |
| Fax: |
Provider Mailing Location
301 ANDREWS AVE.
FORT RUCKER
AL
36362
Provider Mailing Phone/Fax
| Phone: | 3342557973 |
| Fax: |