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NPI 1801426721

NPI 1801426721 : FERN L BLIZZARD RN, HEALTH EDUCATOR : GREEN VALLEY, AZ

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General NPI Number Information
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    NPI Number           |    1801426721
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    Entity Type          |    Individual 
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    Provider Name        |    FERN L BLIZZARD RN, HEALTH EDUCATOR
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/20/2020
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    Last Update Date     |    01/20/2020
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Provider Practice Location Address
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    Address Line         |    1932 E CLIFF SWALLOW TRL 
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    City                 |    GREEN VALLEY
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    State                |    AZ
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    Zip                  |    85614-6026
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    Country              |    US
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    Telephone            |    901-604-3347
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1932 E CLIFF SWALLOW TRL 
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    City                 |    GREEN VALLEY
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    State                |    AZ
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    Zip                  |    85614-6026
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    Country              |    US
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    Telephone            |    901-604-3347
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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        |    174H00000X
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    Taxonomy Name        |    Health Educator
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    License Number       |    
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    License Number State |    
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