Individual
MS. MARY A BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
601 COLLIERS WAY, WEIRTON, WV 26062-5014
(304) 797-6495
Mailing address
601 COLLIERS WAY, WEIRTON, WV 26062-5014
(304) 797-6495
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
42708
WV
Other
Enumeration date
12/14/2022
Last updated
12/14/2022
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