Individual
CANAAN BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
2511 OLD CORNWALLIS RD, SUITE 200, DURHAM, NC 27713-1869
(919) 932-5700
(919) 933-6881
Mailing address
2511 OLD CORNWALLIS RD, SUITE 200, DURHAM, NC 27713-1869
(919) 932-5700
(919) 933-6881
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
280433
NC
Other
Enumeration date
12/18/2015
Last updated
12/18/2015
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