Individual
JORDAN BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
433 BOLIVAR ST, NEW ORLEANS, LA 70112-7021
(504) 428-6287
Mailing address
433 BOLIVAR ST, NEW ORLEANS, LA 70112-7021
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/25/2025
Last updated
06/25/2025
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