Provider Demographics
NPI:1407645799
Name:BLANTON, TERRI
Entity type:Individual
Prefix:
First Name:TERRI
Middle Name:
Last Name:BLANTON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9405 WINDING LN
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-1156
Mailing Address - Country:US
Mailing Address - Phone:513-266-3880
Mailing Address - Fax:
Practice Address - Street 1:9405 WINDING LN
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:OH
Practice Address - Zip Code:45140-1156
Practice Address - Country:US
Practice Address - Phone:513-266-3880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-02
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.116539.MEDS164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse