Individual
BLAKE WRAY STANDIFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
411 LAUREL ST STE A250, DES MOINES, IA 50314-3029
(515) 235-5000
(515) 288-6713
Mailing address
PO BOX 9170, DES MOINES, IA 50306-9170
(515) 633-3600
(515) 633-3838
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
H164471
IA
363LA2100X
Acute Care Nurse Practitioner
H164471
IA
Other
Enumeration date
07/20/2021
Last updated
10/05/2021
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