Individual
GRETCHEN BLEVINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1481 W 10TH ST, INDIANAPOLIS, IN 46202-2803
(812) 478-1825
Mailing address
5080 E BILL FARR DR, TERRE HAUTE, IN 47803-9324
(812) 478-1825
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71004987A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1174930796
NPI
—
01
—
12712350
CAQH
IN
01
—
28215178
NP LICENSE
IN
Enumeration date
07/15/2014
Last updated
03/31/2022
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