Individual
DIANA BLEVINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
530 S JACKSON ST, LOUISVILLE, KY 40202-1675
(502) 562-3000
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3007559
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3007559
LICENSE
KY
05
—
7100218850
—
KY
Enumeration date
08/02/2012
Last updated
11/22/2021
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