Bledsoe, Davina Lynn

Bledsoe, Davina Lynn is an sole proprietor health care provider with primary practice located at 1750 Thompson Rd , Coos Bay OR 97420-2195. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Bledsoe, Davina Lynn can be contacted via phone (541) 269-0333.

Contact Information

Primary practice address
1750 Thompson Rd Coos Bay OR 97420-2195
Phone: (541) 269-0333
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X ARNP9378600 Florida
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 201800261NP-PP Oregon

Profile Details

NPI number 1295245108
LBN Legal business name Bledsoe, Davina Lynn
Credentials FNP-BC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 5th, 2017
Last updated Apr 9th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295245108 NPPES
Oregon MEDICAID 500740413

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