Individual
AMY BLEVINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1300 S ELISEO DR STE 101, GREENBRAE, CA 94904-2014
(415) 497-5420
Mailing address
1300 S ELISEO DR STE 101, GREENBRAE, CA 94904-2014
(415) 497-5420
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
34814
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000
OTHER
—
Enumeration date
09/11/2018
Last updated
09/11/2018
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