BRIAN G BLAKE

MUNSTER, IN
NPI1649876046
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: IL  209.022503)
Enumeration Date2020-12-10
Last Update Date2021-02-08
Business Address
Mr. BRIAN G BLAKE APRN, FNP-BC, RN
8135 CALUMET AVE
MUNSTER, IN 46321-1701
Phone number: 219-513-2000
Mailing Address
Mr. BRIAN G BLAKE APRN, FNP-BC, RN
15604 ROB ROY DR
OAK FOREST, IL 60452-2738
Phone number: 773-771-8197