Individual
MRS. LISA CHRISTINE BLEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1373 E STATE ROAD 62, MADISON, IN 47250-7328
(812) 801-0800
Mailing address
1373 E STATE ROAD 62, MADISON, IN 47250-7328
(812) 801-0800
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3011473
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300025685
—
IN
05
—
7100597820
—
KY
Enumeration date
03/18/2019
Last updated
05/25/2022
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