Blanken, Robert D

Blanken, Robert D is an individual health care provider with primary practice located at 1 Shircliff Way , Jacksonville FL 32204-4748. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Blanken, Robert D can be contacted via phone (904) 308-7300.

Contact Information

Primary practice address
1 Shircliff Way Jacksonville FL 32204-4748
Phone: (904) 308-7300
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 15-00330 Kansas

Profile Details

NPI number 1134197247
LBN Legal business name Blanken, Robert D
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 14th, 2006
Last updated May 23rd, 2013 - about 11 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 1134197247 NPPES
Kansas Other 970016674 RAILROAD MEDICARE
Kansas MEDICAID 100343040B RAILROAD MEDICARE

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