Provider Demographics
NPI:1730774217
Name:BLANKENSHIP, CHRISTOPHER GRANT (APRN-CNP)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:GRANT
Last Name:BLANKENSHIP
Suffix:
Gender:M
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:365 COURTHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:WV
Mailing Address - Zip Code:24740-2431
Mailing Address - Country:US
Mailing Address - Phone:304-425-3922
Mailing Address - Fax:304-487-0229
Practice Address - Street 1:365 COURTHOUSE RD
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:WV
Practice Address - Zip Code:24740-2431
Practice Address - Country:US
Practice Address - Phone:304-425-3922
Practice Address - Fax:304-487-0229
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-05
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV107846363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty