Provider Demographics
NPI:1639712219
Name:BLEVINS, BRIANNA SHERRILL
Entity Type:Individual
Prefix:MRS
First Name:BRIANNA
Middle Name:SHERRILL
Last Name:BLEVINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 BLUFF COVE RD
Mailing Address - Street 2:
Mailing Address - City:WEAVERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28787-9259
Mailing Address - Country:US
Mailing Address - Phone:828-450-3885
Mailing Address - Fax:
Practice Address - Street 1:78 WEAVER BLVD
Practice Address - Street 2:
Practice Address - City:WEAVERVILLE
Practice Address - State:NC
Practice Address - Zip Code:28787-9322
Practice Address - Country:US
Practice Address - Phone:182-845-0388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-25
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA4976225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant