Provider Demographics
NPI:1306688692
Name:BLOUIN, DOREEN M (RN)
Entity type:Individual
Prefix:
First Name:DOREEN
Middle Name:M
Last Name:BLOUIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 SYMMES RD
Mailing Address - Street 2:
Mailing Address - City:EFFINGHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03882-8107
Mailing Address - Country:US
Mailing Address - Phone:603-707-7313
Mailing Address - Fax:
Practice Address - Street 1:1857 WHITE MOUNTAIN HWY STE A1
Practice Address - Street 2:
Practice Address - City:NORTH CONWAY
Practice Address - State:NH
Practice Address - Zip Code:03860-5158
Practice Address - Country:US
Practice Address - Phone:603-707-7313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH043706-21163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Single Specialty