Individual
MYSTI BLIZZARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
1505 W SHERMAN AVE STE 101, VINELAND, NJ 08360-7059
(856) 696-9550
Mailing address
1505 W SHERMAN AVE STE 101, VINELAND, NJ 08360-7059
(856) 696-9550
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26NJ00765900
NJ
Other
Enumeration date
11/08/2017
Last updated
11/08/2017
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