Individual
ALISON BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
123 N 500 E, PAYSON, UT 84651-1932
(801) 377-0580
(801) 375-5582
Mailing address
123 N 500 E, PAYSON, UT 84651-1932
(801) 377-0580
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F07190056
UT
Other
Enumeration date
07/01/2019
Last updated
06/29/2021
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