Individual
MS. ELIZABETH MARIE BLEVINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3336 PUTNAM RD, CLARKSBURG, OH 43115
(740) 993-2302
Mailing address
3336 PUTNAM RD, CLARKSBURG, OH 43115
(740) 993-2302
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN091883
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2705693
—
OH
Enumeration date
08/22/2007
Last updated
08/22/2007
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