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Misty Leann Blanton

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

PECOS Enrollment

This provider is enrolled in PECOS as MISTY BLANTON.

Based on the most recent information from CMS, provider Misty Leann Blanton is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 11:47 AM.

Profile Details

Provider ID
1518601731
Provider Type
Individual
Full Name
Blanton, Misty Leann
Gender
Female

Sole Proprietor
No
Enumeration Date
4/25/2022
Last Updated
7/14/2022

Contact Information

Practice Location

300 Carrera Dr, London, KY 40741-6303

(606) 260-8962

Unlisted Fax

Mailing Location

PO Box 102, Baxter, KY 40806-0102

(606) 273-5261

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363L00000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 3017644 Kentucky

Misty Leann Blanton

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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Cumberland Orthopaedic & Sports Medicine-Arnp

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Prewitt, Adam

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Fuse Medical

Philpot, Chelsey Blake