NPI | 1407100571 |
---|---|
Former Name | ASHLEY E BLAKE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NH 064194-23) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO APN.0993094-NP) |
Enumeration Date | 2012-10-29 |
Last Update Date | 2023-03-28 |