Provider Demographics
NPI:1801426721
Name:BLIZZARD, FERN L (RN, HEALTH EDUCATOR)
Entity type:Individual
Prefix:
First Name:FERN
Middle Name:L
Last Name:BLIZZARD
Suffix:
Gender:F
Credentials:RN, HEALTH EDUCATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1932 E CLIFF SWALLOW TRL
Mailing Address - Street 2:
Mailing Address - City:GREEN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85614-6026
Mailing Address - Country:US
Mailing Address - Phone:901-604-3347
Mailing Address - Fax:
Practice Address - Street 1:1932 E CLIFF SWALLOW TRL
Practice Address - Street 2:
Practice Address - City:GREEN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85614-6026
Practice Address - Country:US
Practice Address - Phone:901-604-3347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-20
Last Update Date:2020-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Single Specialty