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1972666154
CHARLES EDWARD BLAKE
GLENDALE, AZ
NPI
1972666154
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: AZ AP2395)
Enumeration Date
2006-12-18
Last Update Date
2024-05-09
Business Address
Mr. CHARLES EDWARD BLAKE FNP-BC
17215 N 72ND DR BLDG D
GLENDALE, AZ 85308-8558
Phone number: 480-214-9000
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Mailing Address
Mr. CHARLES EDWARD BLAKE FNP-BC
2051 W CHANDLER BLVD STE 5
CHANDLER, AZ 85224-6239
Phone number: 480-214-9000
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