Individual
KYLE TRAVIS BLEVINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
6721 REGENTS BLVD, UNIVERSITY PLACE, WA 98466-5461
(253) 433-7755
Mailing address
1764 COLOGNA RD, MARSHFIELD, MO 65706-9940
(417) 859-6575
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN61575677
WA
164W00000X
Licensed Practical Nurse
Primary
LP61138348
WA
Other
Enumeration date
02/04/2022
Last updated
01/12/2026
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