Provider Demographics
NPI:1841073392
Name:BLYLER, JENNIFER SUE
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:SUE
Last Name:BLYLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 EAST NORTH AVENUE
Mailing Address - Street 2:LEVEL ONE
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212
Mailing Address - Country:US
Mailing Address - Phone:412-325-5700
Mailing Address - Fax:
Practice Address - Street 1:314 EAST NORTH AVENUE
Practice Address - Street 2:LEVEL ONE
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212
Practice Address - Country:US
Practice Address - Phone:412-325-5700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP028057363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner