Organization
NES WASHINGTON, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BLAKEMAN (PROVIDER ENROLLMENT)
(469) 557-6183
Entity
Organization
Contact information
Practice address
3100 TONGASS AVE, KETCHIKAN, AK 99901
(907) 225-5171
Mailing address
7300 STATE HIGHWAY 121 STE 370-374, MCKINNEY, TX 75070-1987
(469) 557-6183
(469) 640-6671
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1571009
—
AK
01
—
DR7134
RR MEDICARE
—
Enumeration date
11/19/2010
Last updated
10/25/2024
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