Individual
MRS. DAISY BLYTHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1481 W 10TH ST, INDIANAPOLIS, IN 46202-2803
(317) 988-1772
(317) 988-5385
Mailing address
1481 W 10TH ST, INDIANAPOLIS, IN 46202-2803
(317) 988-1772
(317) 988-5385
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
28094739A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28094739A
NURSING LICENSE
IN
Enumeration date
03/06/2023
Last updated
03/06/2023
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