Provider Demographics
NPI:1558466748
Name:BLEVINS, JOYCE HENSLEY (CRNP)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:HENSLEY
Last Name:BLEVINS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 ACORN CIR
Mailing Address - Street 2:
Mailing Address - City:POCOMOKE CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21851-9592
Mailing Address - Country:US
Mailing Address - Phone:410-957-0011
Mailing Address - Fax:410-742-5309
Practice Address - Street 1:1208 PEMBERTON DR
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-2402
Practice Address - Country:US
Practice Address - Phone:410-742-7660
Practice Address - Fax:410-742-5309
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR069549363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner