Provider Demographics
NPI:1831311711
Name:BLEVINS, CHRISTY MCGHEE (NP)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:MCGHEE
Last Name:BLEVINS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CHRISTY
Other - Middle Name:MICHELLE
Other - Last Name:MCGHEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16000 JOHNSTON MEMORIAL DR
Mailing Address - Street 2:SUITE 309
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24211-7659
Mailing Address - Country:US
Mailing Address - Phone:276-258-1760
Mailing Address - Fax:276-258-1765
Practice Address - Street 1:3170 LINDEN DR
Practice Address - Street 2:SUITE 6
Practice Address - City:BRISTOL
Practice Address - State:VA
Practice Address - Zip Code:24202-5940
Practice Address - Country:US
Practice Address - Phone:276-591-3687
Practice Address - Fax:276-591-3627
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024167311363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1831311711Medicaid
VAVAA104114Medicare PIN