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Individual

MARYBETH BLOOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
111 STATE ROUTE 35, CLIFFWOOD, NJ 07721-1512
(732) 727-2555
Mailing address
63 E SHORE RD, DENVILLE, NJ 07834-2026
(862) 242-9412

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
26NJ01123100
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0856924
NJ
Enumeration date
06/03/2021
Last updated
04/03/2023
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