Individual
MRS. CARRIE NICHOLE BLEVINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
805 W. KANSAS, JAL, NM 88252
(575) 395-3400
(575) 395-2235
Mailing address
831 CORTO, HOBBS, NM 88240-1094
(575) 691-9573
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CNP-01862
NM
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
CNP-01862
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10708081
—
NM
01
—
2022092898
PMHNP BOARD CERTIFICATION
NM
01
—
F0911364
NP BOARD CERTIFICATION
NM
Enumeration date
11/01/2011
Last updated
05/24/2024
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