Individual
CATHERINE BLYTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1250 CHESTER BLVD., SUITE 1, RICHMOND, IN 47374-1944
(765) 935-8594
(765) 935-8595
Mailing address
1100 REID PKWY, MEDICAL STAFF SERVICES, RICHMOND, IN 47374-1157
(765) 935-8594
(765) 935-8595
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71006855A
IN
363LF0000X
Family Nurse Practitioner
APRN.CNP.019394
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001071340
ANTHEM
—
05
—
0205837
—
OH
05
—
300000316
—
IN
Enumeration date
08/11/2016
Last updated
05/12/2021
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