MRS. BONNIE LYNN BLACKBURN (NPI# 1386270908) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386270908 |
| Entity Type | Individual |
| Full Name | MRS. BONNIE LYNN BLACKBURN |
| Credential | PA |
| Practice Address |
10 Amalia Dr Ste C5 Buckhannon WV 26201-2270 |
| Mailing Address |
1 Amalia Dr Buckhannon WV 26201-2239 |
| Practice Telephone | 3044607948 |
| Practice Fax Number | 3044607908 |
| Mailing Telephone | 3044732000 |
| Enumeration Date | 2020-03-15 |
| Last Update Date | 2020-09-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
2411 | WV | Physician Assistants & Advanced Practice Nursing Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1200 Greenway Rd, Suffolk, VA 234389808 | 7573281586 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649775131 | Bonnie Blackburn | Student in an Organized Health Care Education/Training Program | 1401 St Joseph Pkwy Bldg 1106a, Houston, TX 77002-8301 | 2018-03-27 |
| Street Address |
10 AMALIA DR STE C5 |
| City | BUCKHANNON |
| State | WV |
| Zip Code | 26201-2270 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417570334 | Susan Boyce | Homemaker | 62692 Tallmasville Road, Buckhannon, WV 26201 | 2020-05-27 |
| 1316590177 | Jk Marketing, LLC | Clinic/Center | 4 Hartman Plaza, Buckhannon, WV 26201 | 2019-07-22 |
| 1841759412 | Deborah Lynn Wilson | Massage Therapist | 47 East Main St., Suite 202, Buckhann, WV 26201 | 2019-03-13 |
| 1275041766 | Town of Anmoore Vol Fire Dept | Ambulance | 100 S Ash Street, Anmoore, WV 26201 | 2018-01-18 |
| 1265824411 | Erik Brown | Specialist/Technologist | 36 College Avenue, Buckhannon, WV 26201 | 2015-02-25 |
| 1053735118 | Jonas Layne Phares | Chiropractor | Rt 20 Professional Arts Plaza Dr, Buckhannon, WV 26201 | 2014-02-10 |
| 1750621132 | Drew Foster Mason | Specialist/Technologist | 54 College Avenue, Box 1746, Buckhannon, WV 26201 | 2013-02-22 |
| 1295070241 | Cynthia Jean Hurst | Physician Assistant | 50 Bu Drive, Buckhannon, WV 26201 | 2012-12-03 |
| 1679876197 | Holly Evans | Pharmacist | Route 20 South, Buckhannon, WV 26201 | 2010-12-07 |
| 1407069990 | Upshur-buckhannon Health Department | Public Health or Welfare | 15 North Locust Street, Buckhannon, WV 26201 | 2007-05-08 |
| Find all providers in zip 26201 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295070241 | Cynthia Jean Hurst | Physician Assistant | 50 Bu Drive, Buckhannon, WV 26201 | 2012-12-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922638824 | Sara B Johnson | Physician Assistant | 1000 Mon Health Medical Park Dr Ste 1100, Morgantown, WV 26505-1143 | 2020-01-19 |
| 1659835072 | Kristen Nicole Williams | Physician Assistant | 26 Portsmouth Ct N, Falling Waters, WV 25419-1430 | 2019-01-30 |
| 1629588876 | Robert Theodore Hartman | Physician Assistant | 620 National Rd Ste 300, Wheeling, WV 26003-6560 | 2017-10-02 |
| 1366967986 | Terri Leanne Belcher | Physician Assistant | 395 Emily Dr, Clarksburg, WV 26301-5505 | 2017-08-04 |
| 1760937056 | Ryan Aston | Physician Assistant | 58 16th St Fl 4, Wheeling, WV 26003-3660 | 2016-08-17 |
| 1821470113 | Lesley E. Weiss | Physician Assistant | 3200 Maccorkle Seave, Charleston, WV 25304-1227 | 2015-06-23 |
| 1891197323 | Rachelle Lyle Stewart | Physician Assistant | 1500 Terrace St Ste 105, Hinton, WV 25951-9768 | 2014-09-16 |
| 1285043224 | Sarah Gutman Brammer | Physician Assistant | 30 Medical Park Ste 211, Wheeling, WV 26003-6391 | 2014-08-04 |
| 1841603529 | Timothy Douglas | Physician Assistant | 4202 Mccorkle Ave Sw Ste 200, South Charleston, WV 25309-1513 | 2014-06-10 |
| 1023432093 | Megan Noel Blackburn | Physician Assistant | 1500 Grand Central Ave Ste 115, Parkersburg, WV 26105-1079 | 2014-02-12 |
| Find all providers with the same taxonomy | ||||
| City | BUCKHANNON |
| Zip Code | 26201 |
Please comment or provide details below to improve the information on MRS. BONNIE LYNN BLACKBURN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.