NPI 1235687757

Jessica D Blanke, PA

Practitioner Surgical Physician Assistant O Fallon, MO

Practice location

Address: 7827 Highway N STE 104, O Fallon, MO 63368-6704
Phone: (636) 377-1177
Fax: (636) 377-1911

Registered specialties

Surgical Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363AS0400X Licence 168548 (MO)

Other Physician Assistant providers in Missouri →

Registry record

NPI: 1235687757
Entity type: Individual
Sex (as registered): Female
NPI issued: 13 Sep 2016
Record last updated: 14 Sep 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.