Individual
MRS. WENDY NICOLE BLETHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NNP-BC
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5262
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5262
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
ARNP9391501
FL
363LN0000X
Neonatal Nurse Practitioner
R862823
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08577001
—
MS
Enumeration date
06/18/2006
Last updated
02/03/2016
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