Provider Demographics
NPI:1780635094
Name:BLEVINS, KATHRYN A (RNC)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:A
Last Name:BLEVINS
Suffix:
Gender:F
Credentials:RNC
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Mailing Address - Street 1:213 COOK AVE
Mailing Address - Street 2:
Mailing Address - City:CHAFFEE
Mailing Address - State:MO
Mailing Address - Zip Code:63740-1107
Mailing Address - Country:US
Mailing Address - Phone:573-887-6924
Mailing Address - Fax:573-332-0444
Practice Address - Street 1:SEMO NASV 69 DOCTORS' PARK
Practice Address - Street 2:SUITE C
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63703-4927
Practice Address - Country:US
Practice Address - Phone:573-332-1900
Practice Address - Fax:573-332-0444
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MORN099191363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health