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General NPI Number Information
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NPI Number | 1548389968
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Entity Type | Individual
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Provider Name | ROXANNE B BLISS ARNP
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Gender | Female
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | 41 JUDGE LN
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City | BETHLEHEM
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State | CT
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Zip | 06751-1902
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Country | US
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Telephone | 203-244-8411
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Fax |
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Provider Business Mailing Address
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Address Line | 20 HOPMEADOW ST UNIT 802
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City | WEATOGUE
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State | CT
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Zip | 06089-7937
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Country | US
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Telephone | 509-435-6083
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 12548
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License Number State | CT
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