BLAISE FONDREN

MEMPHIS, TN
NPI1679341630
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: TN  36596)
Additional Taxonomies163W00000X Registered Nurse
(Licence: MS  899036)
363LF0000X Nurse Practitioner, Family
(Licence: MS  906484)
Enumeration Date2023-12-19
Last Update Date2024-10-03
Business Address
BLAISE FONDREN
6401 POPLAR AVE
MEMPHIS, TN 38119-4823
Phone number: 901-525-3086
Mailing Address
BLAISE FONDREN
420 LIVE OAK DR
OXFORD, MS 38655-2962
Phone number: 901-337-5548