Blank, Nancy Marie

Blank, Nancy Marie is an individual health care provider with primary practice located at 2560 Business Park Dr Ne , Cleveland TN 37311-6503. She recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as her primary health care specialty. Blank, Nancy Marie can be contacted via phone (423) 472-5401.

Contact Information

Primary practice address
2560 Business Park Dr Ne Cleveland TN 37311-6503
Phone: (423) 472-5401
Fax: (423) 479-3060
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X MD0000015363 Tennessee

Profile Details

NPI number 1356346720
LBN Legal business name Blank, Nancy Marie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2005
Last updated Nov 30th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356346720 NPPES
Tennessee Other 30092801 MEDICARE ID - PTAN
Tennessee MEDICAID 3009288 MEDICARE ID - PTAN

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