JACQUELYN NIKOL BLAKE

SAINT LOUIS, MO
NPI1770058299
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy164W00000X Licensed Practical Nurse
(Licence: MO  055560)
Enumeration Date2018-10-11
Last Update Date2018-10-11
Business Address
Ms. JACQUELYN NIKOL BLAKE LPN
5471 DR MARTIN LUTHER KING DR
SAINT LOUIS, MO 63112-4265
Phone number: 314-367-5820
Mailing Address
Ms. JACQUELYN NIKOL BLAKE LPN
5471 DR MARTIN LUTHER KING DR
SAINT LOUIS, MO 63112-4265
Phone number: 314-367-5820