Individual provider · Type 1 NPI

Bonnie Lynn Blackburn, PA

Medical Physician Assistant · Buckhannon, WV

NPI number 1386270908 Active

Practice location

10 Amalia Dr Ste C5
Buckhannon, WV 26201-2270

Call (304) 460-7948 Map

Fax (304) 460-7908

Mailing address

1 Amalia Dr
Buckhannon, WV 26201-2239

Other practice locations

  • 1200 Greenway Rd, Suffolk, VA 23438-9808 · (757) 328-1586

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X2411 (WV)
Student in an Organized Health Care Education/Training Program 390200000XNone listed

Medical Physician Assistant: Definition to come...

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About NPI 1386270908

Bonnie Lynn Blackburn, PA's National Provider Identifier is 1386270908, issued on Mar 15, 2020. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Buckhannon, WV. The record was last updated on Sep 15, 2020.