| Doctor Name: | MRS. CAROLYN ANN BLYTHE |
| NPI Number: | 1669496915 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PMHNP |
| License Number: | R606391 |
| Business Practice Address: | 79 Pink Smith Rd Carriere, MS - 394268641 |
| Business Phone Number: | 6017493887 |
| Business Fax Number: | 6017493887 |
| Mailing Address: | 79 Pink Smith Rd, CARRIERE |
| State: | MS |
| Postal Code: | 394268641 |
| Phone Number: | 6017493887 |
| Fax Number: | |
| NPI Enumeration Date: | 07/27/2006 |
| NPI Last Update Date: | 03/10/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | R606391 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |