Blanton, Mary Jo

Blanton, Mary Jo is an individual health care provider with primary practice located at 36 Pemberton Cv , Jackson TN 38305-5514. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Blanton, Mary Jo can be contacted via phone (731) 394-1145.

Contact Information

Primary practice address
36 Pemberton Cv Jackson TN 38305-5514
Phone: (731) 394-1145
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X R858448 Mississippi
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 20157 Tennessee

Profile Details

NPI number 1497784466
LBN Legal business name Blanton, Mary Jo
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 2nd, 2006
Last updated Jan 18th, 2022 - about 4 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 1497784466 NPPES
Mississippi MEDICAID 01674813

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