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Individual

JOY O BLAINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NPC

Contact information

Practice address
2333 WHITEHORSE MERCERVILLE RD, STE 4, MERCERVILLE, NJ 08619-1946
(609) 890-9111
(609) 890-6865
Mailing address
2333 WHITEHORSE MERCERVILLE RD, STE 4, MERCERVILLE, NJ 08619-1946
(609) 890-9111
(609) 890-6865

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
Q26728
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0054470
NJ
Enumeration date
02/28/2006
Last updated
09/27/2007
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