Healthcare Provider Details

I. General information

NPI: 1689500092
Provider Name (Legal Business Name): NYTROYANA BLAND LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

731 35TH ST NE
CEDAR RAPIDS IA
52402-3603
US

IV. Provider business mailing address

731 35TH ST NE
CEDAR RAPIDS IA
52402-3603
US

V. Phone/Fax

Practice location:
  • Phone: 319-250-2970
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberP68054
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: