Crissa Carolyn Blankenberg, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

315182 Issued in NY

Practice address

107 N Clinton Ave
Rochester, NY 14604-1411

Phone

(585) 324-3100

NPI assigned

Nov 13, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1542067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542067200000",
    "number": "1033687629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 ARROWHEAD DR",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146242804",
            "telephone_number": "585-730-0693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 N CLINTON AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146041411",
            "telephone_number": "585-324-3100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "134 Arrowhead Dr",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146242804",
            "country_code": "US",
            "telephone_number": "585-730-0693",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLANKENBERG",
        "first_name": "CRISSA",
        "middle_name": "CAROLYN",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-13",
        "last_updated": "2018-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "315182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christie Blanda, CASAC
• Eddie Blanding Jr., LMSW
• Quentara Blanding, LPN
• Jared Blank, MS PT
• Christopher Ryan Blankenberg, P.T.
• Blankenheim Occupational Therapy
• Paul Joseph Blasio, M.D.
• Anthony Blaskovic
• Sabrina Rose Blaskovic
• Gabrielle Blaszczyk, PA

• Licensed Practical Nurse in Rochester, NY
• Providers in Rochester, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.