Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Gerontology |
363LG0600X | 50 | Nurse Practitioner |
| NPI Number | 1639619216 |
| LBN Legal business name | BLAKEWELL HEALTH |
| Authorized official | INDIA MICHEL - (PRACTICE ADMINISTRATOR) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 03/02/2017 |
| Last updated | 05/03/2017 - About 9 years ago |
| Identifiers | n/a |
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BLAKEWELL HEALTH
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