Provider Demographics
NPI:1609549716
Name:BLEVINS, SHARON (FNP-C)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:BLEVINS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2012 GARFIELD AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26101-2541
Mailing Address - Country:US
Mailing Address - Phone:304-983-9090
Mailing Address - Fax:
Practice Address - Street 1:2012 GARFIELD AVE STE 2
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-2541
Practice Address - Country:US
Practice Address - Phone:304-893-9090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-26
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV110218363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily