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Contact Information

KELLY J BLEAKNEY
106 BLANCA AVE
ALAMOSA, CO81101-2340
 Phone: 719-589-2511
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
 

Registered Nurse

163W00000X
Indicates primary specialty

NPI Profile & details for KELLY J BLEAKNEY · (Female)

NPI Number 1235764374
Status Active
Credentials
Entity Individual
Enumeration date 03/09/2020
Last updated 02/11/2021 - About 5 years ago
Sole proprietor 1 Yes
Identifiers
  • CO License # 0161722
  • CO License # APN.0996244-NP
Hospital affiliation(s)
  • SAN LUIS VALLEY REGIONAL MEDICAL CENTER - (Acute Care)
    106 BLANCA AVE
    ALAMOSA, CO 81101
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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