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Individual
AMY REED BLEVINS
Active
Individual
AMY REED BLEVINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024165275
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004945298
—
VA
01
—
01451713
AMERGROUP
VA
01
—
C04810
MEDICARE GROUP
VA
01
—
P00017719
MEDICARE RAILROAD
—
Enumeration date
04/14/2006
Last updated
11/20/2012
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