Individual
TRACY CHARLESTON-BLAKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 CANDLEWYCK DR APT 1201, KALAMAZOO, MI 49001-6800
(269) 271-7178
Mailing address
300 CANDLEWYCK DR APT 1201, KALAMAZOO, MI 49001-6800
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703091237
MI
Other
Enumeration date
09/11/2024
Last updated
09/11/2024
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