Individual
BLYTH COREY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1004 PENNSYLVANIA AVE, UNIVERSITY CITY, MO 63130-2325
(314) 240-5613
Mailing address
149 CRESTMONT CIR, GROVER, MO 63040-1623
(636) 577-2987
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2008023234
MO
Other
Enumeration date
07/06/2016
Last updated
07/06/2016
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