IndividualActive
Jessica Blanke, PA
NPI 1235687757 · Surgical Physician Assistant · O Fallon, MO
Provider details
- NPI number
- 1235687757
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA
- Sex
- Female
- Sole proprietor
- No
- License
- 168548 (MO)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
7827 Highway N Ste 104
O Fallon, MO 63368-6704
Phone: (636) 377-1177
Fax: (636) 377-1911
Approximate (ZIP-level) locationGet directions
Mailing address
7827 Highway N Ste 104
O Fallon, MO 63368-6704
Registry dates
- Enumerated
- 2016-09-13
- Last updated
- 2016-09-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.