Provider Demographics
NPI:1871153569
Name:BLANKENSHIP, LINDSEY TAYLOR (PA-C)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:TAYLOR
Last Name:BLANKENSHIP
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:TAYLOR
Other - Last Name:GATEAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:13950 BRANDYWINE RD STE 225
Mailing Address - Street 2:
Mailing Address - City:BRANDYWINE
Mailing Address - State:MD
Mailing Address - Zip Code:20613-5815
Mailing Address - Country:US
Mailing Address - Phone:301-856-1682
Mailing Address - Fax:301-526-0964
Practice Address - Street 1:13950 BRANDYWINE RD
Practice Address - Street 2:
Practice Address - City:BRANDYWINE
Practice Address - State:MD
Practice Address - Zip Code:20613-5815
Practice Address - Country:US
Practice Address - Phone:301-856-1682
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-16
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant