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General NPI Number Information
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NPI Number | 1992894331
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Entity Type | Individual
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Provider Name | BONNIE BLEVINS R.N.
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Gender | Female
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 12/20/2013
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Provider Practice Location Address
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Address Line | 1150 STATE HIGHWAY 248 SUITE 200
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City | BRANSON
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State | MO
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Zip | 65616-3758
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Country | US
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Telephone | 417-336-4112
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Fax | 417-335-4684
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Provider Business Mailing Address
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Address Line | 1150 STATE HIGHWAY 248 STE 200
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City | BRANSON
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State | MO
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Zip | 65616-4186
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Country | US
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Telephone | 417-336-4112
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Fax | 417-335-4684
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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 | 364S00000X
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Taxonomy Name | Clinical Nurse Specialist
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License Number | 309-001816
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License Number State | IL
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