Provider Demographics
NPI:1053830430
Name:BLAY, BEATRICE MARY (FNP)
Entity Type:Individual
Prefix:
First Name:BEATRICE
Middle Name:MARY
Last Name:BLAY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:BEATRICE
Other - Middle Name:
Other - Last Name:BLE AFIBA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:350 FALCON RIDGE PKWY STE 102
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:NV
Mailing Address - Zip Code:89027-8879
Mailing Address - Country:US
Mailing Address - Phone:702-345-3312
Mailing Address - Fax:
Practice Address - Street 1:350 FALCON RIDGE PKWY STE 102
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:NV
Practice Address - Zip Code:89027-8879
Practice Address - Country:US
Practice Address - Phone:678-791-5343
Practice Address - Fax:702-345-3374
Is Sole Proprietor?:No
Enumeration Date:2017-09-17
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPRN002707363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily