| NPI | 1396235198 |
|---|---|
| Former Name | JENNIFER LYNN BLEVINS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: WV APRN99617NP) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 3012263) |
| Enumeration Date | 2018-05-16 |
| Last Update Date | 2018-05-16 |