Organization
NEW BEGINNINGS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLYN BLYTHE A. BLYTHE PHMNP (PROVIDER)
(601) 749-3887
Entity
Organization
Contact information
Practice address
79 PINK SMITH RD, CARRIERE, MS 39426-8641
(601) 749-3887
Mailing address
79 PINK SMITH RD, CARRIERE, MS 39426-8641
(601) 749-3887
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
R606391
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04007878
—
MS
01
—
433667051B
BLUE CROSS BLUE SHIELD
MS
Enumeration date
07/05/2007
Last updated
07/11/2008
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