Provider Demographics
NPI:1093073579
Name:BLIZZARD, SARAH LYNN (APRN)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:LYNN
Last Name:BLIZZARD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5043 BLUE MAJOR DR
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-3108
Mailing Address - Country:US
Mailing Address - Phone:407-506-2575
Mailing Address - Fax:
Practice Address - Street 1:12280 LAKE UNDERHILL RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-5009
Practice Address - Country:US
Practice Address - Phone:407-273-3284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-02
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9171825363LF0000X, 363LP0808X
FLAPRN9171825363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily