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Individual

JENNIFER JANE BLEVINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1302 W CRAIG RD STE A, N LAS VEGAS, NV 89032-0247
(702) 473-8380
(702) 473-8383
Mailing address
6355 S BUFFALO DR FL 3, LAS VEGAS, NV 89113-2133
(702) 216-3346
(702) 671-6883

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA20701
CA
363A00000X
Physician Assistant
Primary
PA2489
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1124357066
NV
01
PA2489
STATE LICENSE
NV
Enumeration date
12/23/2009
Last updated
10/02/2023
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