Individual provider · Type 1 NPI
Annie Blystone
Psychiatric/Mental Health Nurse Practitioner · Tamarac, FL
NPI number
1104617513
Active
Practice location
7425 N University Dr
Tamarac, FL 33321-2901
Fax (603) 461-3545
Mailing address
PO Box 4228
Portland, OR 97208-4228
Other practice locations
- 1250 SW Veterans Way Ste 120, Redmond, OR 97756-2588 · (541) 383-3005
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 10001248 (OR) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | APRN11039470 (FL) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
3 other providers at this address
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About NPI 1104617513
Annie Blystone's National Provider Identifier is 1104617513, issued on May 14, 2025. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Tamarac, FL. The record was last updated on May 20, 2026.