Individual
MR. RAYMOND PATRICK BLYTHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CFNP
Contact information
Practice address
2809 DENNY AVE, PASCAGOULA, MS 39581-5301
(228) 809-5510
(228) 809-5519
Mailing address
2101 HIGHWAY 90, GAUTIER, MS 39553-5340
(228) 497-7576
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
R871321
MS
363LF0000X
Family Nurse Practitioner
Primary
R871321
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01680060
—
MS
Enumeration date
08/29/2013
Last updated
05/20/2022
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