NPI Profile for KELLY J BLEAKNEY in ALAMOSA, CO.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Family |
363LF0000X | 50 | Nurse Practitioner | |
Registered Nurse |
163W00000X |
| 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 |
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| Hospital affiliation(s) |
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KELLY J BLEAKNEY
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