Healthcare Provider Details

I. General information

NPI: 1457268971
Provider Name (Legal Business Name): NATHAN RAY BLEVINS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1402 4TH AVE
HUNTINGTON WV
25701-2403
US

IV. Provider business mailing address

901 NEW BUCKLEY RD
ASHLAND KY
41102-8828
US

V. Phone/Fax

Practice location:
  • Phone: 606-385-0369
  • Fax:
Mailing address:
  • Phone: 606-385-0369
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146E00000X
TaxonomyCommunity Paramedic
License Number1621-P
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code156F00000X
TaxonomyTechnician/Technologist
License NumberH9A87D3E6
License Number State
# 3
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License NumberH9A8D3E6
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: