Individual
STEPHANIE MCCALLUM BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, NNP-BC
Contact information
Practice address
2301 ERWIN RD, DURHAM, NC 27705-4699
(919) 681-5551
Mailing address
201 E CENTER ST APT 401, MEBANE, NC 27302-2577
(919) 423-6885
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
930229
NC
363LN0000X
Neonatal Nurse Practitioner
Primary
122339
NC
Other
Enumeration date
04/15/2008
Last updated
12/10/2024
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