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General NPI Number Information
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NPI Number | 1467309294
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Entity Type | Individual
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Provider Name | TRINITY JARED BLEVINS CNP
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Gender | Male
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Dates
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Enumeration Date | 03/11/2026
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Last Update Date | 03/11/2026
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Provider Practice Location Address
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Address Line | 10755 N US HIGHWAY 25E
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City | GRAY
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State | KY
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Zip | 40734-7099
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Country | US
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Telephone | 606-258-8050
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Fax |
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Provider Business Mailing Address
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Address Line | 164 MICHIGAN AVE
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City | HINKLE
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State | KY
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Zip | 40953-5800
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Country | US
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Telephone | 606-269-4195
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0000X
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Taxonomy Name | Adolescent Medicine (Family Medicine) Physician
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License Number | 4052595
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | 4052595
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4052595
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License Number State | KY
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