Individual provider · Type 1 NPI

Clyde Blaylock, FNP-BC

Nurse Practitioner · Melbourne, FL

NPI number 1154738821 Active

Practice location

8725 N Wickham Rd Ste 301
Melbourne, FL 32940-2240

Fax (321) 434-9202

Mailing address

3300 S Fiske Blvd
Rockledge, FL 32955-4306

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000XARNP9210359 (FL)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1154738821

Clyde Blaylock, FNP-BC's National Provider Identifier is 1154738821, issued on Jul 15, 2014. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Melbourne, FL. The record was last updated on Apr 8, 2019.