| Doctor Name: | MR. LANDON J BLANKENSHIP |
| NPI Number: | 1003278722 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | APRN, FNP-BC |
| License Number: | APRN61531NP |
| Business Practice Address: | 456 Cranberry Dr Beckley, WV - 258018560 |
| Business Phone Number: | 3042556404 |
| Business Fax Number: | 3042556494 |
| Mailing Address: | 456 Cranberry Dr, BECKLEY |
| State: | WV |
| Postal Code: | 258018560 |
| Phone Number: | 3042556404 |
| Fax Number: | 3042556494 |
| NPI Enumeration Date: | 03/22/2016 |
| NPI Last Update Date: | 03/22/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | APRN61531NP |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WV |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |