Provider Demographics
NPI:1871973131
Name:BLANKS, RHONDA ELAINE (CNA)
Entity type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:ELAINE
Last Name:BLANKS
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9114 KAREN MILL CV
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-8533
Mailing Address - Country:US
Mailing Address - Phone:901-406-7274
Mailing Address - Fax:
Practice Address - Street 1:9114 KAREN MILL CV
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38016-8533
Practice Address - Country:US
Practice Address - Phone:901-406-7274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-02
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00170900374U00000X, 376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No374U00000XNursing Service Related ProvidersHome Health Aide