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Individual

MRS. BONNIE BLEVINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
R.N.

Contact information

Practice address
1150 STATE HIGHWAY 248, SUITE 200, BRANSON, MO 65616-3758
(417) 336-4112
(417) 335-4684
Mailing address
1150 STATE HIGHWAY 248 STE 200, BRANSON, MO 65616-4186
(417) 336-4112
(417) 335-4684

Taxonomy

Speciality
Code
Description
License number
State
364S00000X
Clinical Nurse Specialist
Primary
309-001816
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
041-220150
ILLINOIS LICENSE
Enumeration date
10/12/2006
Last updated
12/20/2013
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