Individual
TERRY BLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
4137 N 108TH AVE, PHOENIX, AZ 85037-5459
(623) 877-7337
(623) 772-0686
Mailing address
4137 N 108TH AVE, PHOENIX, AZ 85037-5459
(623) 877-7337
(623) 772-0686
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN098271
AZ
Other
Enumeration date
03/26/2007
Last updated
07/08/2007
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