ANNIE BLYSTONE NPI 1104617513

NPI Information

  • NPI: 1104617513
  • Provider Name: ANNIE BLYSTONE
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 7425 N UNIVERSITY DR
    TAMARAC, FL
    ZIP 33321
  • Phone: (954) 247-4627

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NPI Details

Annie Blystone is a psychiatric/mental health nurse practitioner in Tamarac, FL with 2 years of experience. Annie Blystone NPI is 1104617513. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

7425 N UNIVERSITY DR
TAMARAC, FL
ZIP 33321-901
Phone: (954) 247-4627
Fax: (603) 461-3545

The NPI 1104617513 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/14/2025 and was last updated on 12/29/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0808XNurse PractitionerPsychiatric/Mental HealthAPRN11039470FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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