| Doctor Name: | ANGELA BLOMQUIST |
| NPI Number: | 1023238821 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN, APN, CPNP |
| License Number: | 26NJ00075500 |
| Business Practice Address: | 119 White Horse Pike Haddon Heights, NJ - 080351909 |
| Business Phone Number: | 8565477300 |
| Business Fax Number: | 8565474573 |
| Mailing Address: | 402 Lippincott Dr, MARLTON |
| State: | NJ |
| Postal Code: | 080534112 |
| Phone Number: | 8567823300 |
| Fax Number: | 8565048029 |
| NPI Enumeration Date: | 04/26/2007 |
| NPI Last Update Date: | 09/16/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 26NJ00075500 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |