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1306510805
SHIRONDA R BLAKE
SHREVEPORT, LA
NPI
1306510805
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: LA 221102)
Enumeration Date
2021-08-06
Last Update Date
2022-08-11
Business Address
SHIRONDA R BLAKE NP
3217 MABEL ST
SHREVEPORT, LA 71103-4022
Phone number: 318-631-9121
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Mailing Address
SHIRONDA R BLAKE NP
3217 MABEL ST
SHREVEPORT, LA 71103-4022
Phone number: 318-631-9121
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