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NPI 1194996363

NPI 1194996363 : GAYLINE PATRICIA BLAU RN, BSN, NP : SAIPAN, MP

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General NPI Number Information
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    NPI Number           |    1194996363
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    Entity Type          |    Individual 
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    Provider Name        |    GAYLINE PATRICIA BLAU RN, BSN, NP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/17/2008
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    Last Update Date     |    03/17/2008
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Provider Practice Location Address
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    Address Line         |    1 LOWER NAVY HILL 
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    City                 |    SAIPAN
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    State                |    MP
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    Zip                  |    96950-0409
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    Country              |    US
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    Telephone            |    670-234-8950
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    P.O. BOX 500409 
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    City                 |    SAIPAN
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    State                |    MP
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    Zip                  |    96950-0409
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    Country              |    US
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    Telephone            |    670-234-8950
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    163W00000X
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    Taxonomy Name        |    Registered Nurse
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    License Number       |    R8670
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    License Number State |    MP
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Taxonomy #2
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    Taxonomy Code        |    363L00000X
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    Taxonomy Name        |    Nurse Practitioner
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    License Number       |    0065
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    License Number State |    MP
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