KELECHI BLANTON (NPI# 1598325136) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598325136 |
| Entity Type | Individual |
| Full Name | KELECHI BLANTON |
| Credential | NP |
| Practice Address |
601 S Clay St Ste 105 Ennis TX 75119-5771 |
| Mailing Address |
Po Box 542922 Grand Prairie TX 75054-2922 |
| Practice Telephone | 9728756600 |
| Mailing Telephone | 6122359988 |
| Enumeration Date | 2019-06-17 |
| Last Update Date | 2019-06-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
AP141146 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
AP141146 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
601 S CLAY ST STE 105 |
| City | ENNIS |
| State | TX |
| Zip Code | 75119-5771 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174121859 | Alexandria Etuk | Pharmacist | 101 Sh-437 Spur, Ennis, TX 75119 | 2020-10-14 |
| 1285279158 | Oluchi Ozumba Md Pa | Pain Medicine | 601 S Cly St, Suite 104, Ennis, TX 75119 | 2019-11-14 |
| 1952806085 | Ikids Pediatric Dentistry Ennis, Pllc | Dentist | 711 S Clay St Ste A, Ennis, TX 75119 | 2018-03-29 |
| 1609382068 | Living Single LLC | Residential Treatment Facility, Physical Disabilities | 809 E. Denton Street, Ennis, TX 75119 | 2017-12-21 |
| 1912363300 | Erin Denise Jackson | Counselor | 219 W. Brown St, Suite A, Ennis, TX 75119 | 2016-01-14 |
| 1164769139 | Matthew Garrett Cooper | Nurse Anesthetist, Certified Registered | 2201 W. Lampasas Street, Ennis, TX 75119 | 2013-01-11 |
| 1922343805 | Braces R Us PC | Dentist | 1012 E. Ennis Ave. Ste. C, Ennis, TX 75119 | 2012-12-04 |
| 1154684355 | Stefanie Nicole Rust | Emergency Medicine | 2201 West Lampasas Street, Ennis, TX 75119 | 2012-06-21 |
| 1265710909 | Traditions Health Care of Ennis, LLC | Home Health | 109 Southwest Main Street, Suite A, Ennis, TX 75119 | 2011-07-29 |
| 1578792370 | Peak Physical Therapy and Rehabilitation LLC | Physical Therapist | 2200 Physicians Blvd, Ste D, Ennis, TX 75119 | 2009-07-14 |
| Find all providers in zip 75119 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588262570 | Holly Joyce Carlstrand | Nurse Practitioner | 18 Carmel Chase Ct, Manvel, TX 77578-3452 | 2020-10-13 |
| 1700483690 | Amy Calder | Nurse Practitioner | 14441 Memorial Dr Ste 5, Houston, TX 77079-6708 | 2020-10-05 |
| 1104423300 | Donna Ann Ford | Nurse Practitioner | 1605 Turtle Dr, San Angelo, TX 76904-7708 | 2020-10-01 |
| 1497361653 | Alexis Jolivet | Nurse Practitioner | 8706 Shiloh St, Texas City, TX 77591-2327 | 2020-09-22 |
| 1851906960 | Ann Nnenna Ugbeme | Nurse Practitioner | 1601 Lisburn Dr, Mckinney, TX 75071-3357 | 2020-09-15 |
| 1528673233 | Lashika R Meanus | Nurse Practitioner | 10501 Matador Dr, Mckinney, TX 75072-2952 | 2020-09-10 |
| 1700498391 | Raphael Udalor | Nurse Practitioner | 3631 Campfield Ct, Katy, TX 77449-8621 | 2020-08-17 |
| 1326664020 | Tasha Samantha Leonard | Nurse Practitioner | 622 Orlandis Ln, Rosenberg, TX 77469-5084 | 2020-06-19 |
| 1962025171 | Shewana Spencer | Nurse Practitioner | 613 W Bluff St, Woodville, TX 75979-5125 | 2020-05-21 |
| 1992325906 | Emily Natosha Bennett | Nurse Practitioner | 4323 Dragonwick Dr, Houston, TX 77045-3311 | 2020-04-20 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.