NPI | 1427866706 |
---|---|
Other Name | LAUREN BLAKE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209031934) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041503296) |
Enumeration Date | 2024-12-19 |
Last Update Date | 2025-04-11 |