Provider Demographics
NPI:1558432328
Name:BLEVINS, NANCY YOAKUM (MD)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:YOAKUM
Last Name:BLEVINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 HOSPITAL RD
Mailing Address - Street 2:STE #A
Mailing Address - City:WINCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37398-2494
Mailing Address - Country:US
Mailing Address - Phone:931-962-2229
Mailing Address - Fax:931-967-8918
Practice Address - Street 1:155 HOSPITAL RD
Practice Address - Street 2:STE #A
Practice Address - City:WINCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37398-2494
Practice Address - Country:US
Practice Address - Phone:931-962-2229
Practice Address - Fax:931-967-8918
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD26784207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
3077500OtherBCBSTN
TN3099269Medicaid
F60499Medicare UPIN
TN3099269Medicaid