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General NPI Number Information
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NPI Number | 1558002675
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Entity Type | Individual
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Provider Name | BLYTHE DEMELLO DNP
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Gender | Female
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Dates
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Enumeration Date | 04/05/2022
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Last Update Date | 10/05/2026
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Provider Practice Location Address
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Address Line | 2070 W RUDASILL RD STE 130
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City | TUCSON
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State | AZ
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Zip | 85704-7891
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Country | US
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Telephone | 520-420-2520
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Fax | 520-420-2522
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Provider Business Mailing Address
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Address Line | 5301 E GRANT RD
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City | TUCSON
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State | AZ
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Zip | 85712-2805
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Country | US
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Telephone | 520-420-2520
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 289338
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 1655150
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License Number State | CO
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