Male or Other

Jaxsyn R. Blevins

Peer Specialist in Beckley, WV(View on Map)

Full Name

Jaxsyn Ryker Blevins

NPI Number

1548979644

NPI Type

Individual Provider

Gender

Male

Enumeration Date

11/16/2022

Specialties

(Taxonomies)

Code

175T00000X

Primary Taxonomy

Yes

Contact
Information

Purpose

Mailing
Location

Address

118 ANN ST
118 ANN ST

City

Beckley
Beckley

State

WV
WV

Postal Code

25801-6402
25801-6402

Country

US
US

Telephone Number

(304) 890-0452
(304) 890-0452

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 11/17/2022

Provider Address

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