IndividualActive
Bonnie Blackburn, PA
NPI 1386270908 · Medical Physician Assistant · Buckhannon, WV
Provider details
- NPI number
- 1386270908
- Entity type
- Individual
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA
- Sex
- Female
- Sole proprietor
- No
- License
- 2411 (WV)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Student, Health Care
Practice location
10 Amalia Dr Ste C5
Buckhannon, WV 26201-2270
Phone: (304) 460-7948
Fax: (304) 460-7908
Approximate (ZIP-level) locationGet directions
Mailing address
1 Amalia Dr
Buckhannon, WV 26201-2239
Additional practice locations (1)
- 1200 Greenway RdSuffolk, VA 23438-9808Phone: (757) 328-1586
Registry dates
- Enumerated
- 2020-03-15
- Last updated
- 2020-09-15
- Certified
- 2020-09-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.