Provider Demographics
NPI:1720120777
Name:DUYST, JENNIFER BLYTHE (CFNP, MSN)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:BLYTHE
Last Name:DUYST
Suffix:
Gender:F
Credentials:CFNP, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34611 ROAD 152
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93292-9561
Mailing Address - Country:US
Mailing Address - Phone:559-798-7400
Mailing Address - Fax:
Practice Address - Street 1:1142 ROSE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:SELMA
Practice Address - State:CA
Practice Address - Zip Code:93662-3251
Practice Address - Country:US
Practice Address - Phone:559-891-8940
Practice Address - Fax:559-891-9090
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA397777363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily