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NPI Profile for LESLIE N BLAYLOCK in WARRIOR, AL.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Family |
363LF0000X | 50 | Nurse Practitioner |
| NPI # | 1386100543 |
|
| Status | Active | |
| Credentials | CRNP (Certified Registered Nurse Practitioner) | |
| Entity | Individual | |
| Enumeration date | 02/13/2019 | |
| Last updated | 04/16/2019 - About 7 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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LESLIE N BLAYLOCK
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LESLIE N BLAYLOCK, CRNP