Individual
LAURA ELIZABETH BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, BSN
Contact information
Practice address
488 PEYTON ST, BARBOURSVILLE, WV 25504-2004
(304) 638-9778
Mailing address
488 PEYTON ST, BARBOURSVILLE, WV 25504-2004
(304) 638-9778
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
100269
WV
Other
Enumeration date
06/14/2018
Last updated
06/14/2018
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