Provider Demographics
NPI:1932990983
Name:BLANKENSHIP, MALISSA ONJELAE
Entity type:Individual
Prefix:
First Name:MALISSA
Middle Name:ONJELAE
Last Name:BLANKENSHIP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 LONGHORN LN
Mailing Address - Street 2:
Mailing Address - City:MOHAWK
Mailing Address - State:WV
Mailing Address - Zip Code:24862-6203
Mailing Address - Country:US
Mailing Address - Phone:681-220-8832
Mailing Address - Fax:
Practice Address - Street 1:22 LONGHORN LN
Practice Address - Street 2:
Practice Address - City:MOHAWK
Practice Address - State:WV
Practice Address - Zip Code:24862-6203
Practice Address - Country:US
Practice Address - Phone:681-220-8832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-16
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant