Individual
BLAIR MARIE EAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
4007 SW PORT ST LUCIE BLVD, PORT SAINT LUCIE, FL 34953-5679
(772) 343-1774
Mailing address
1462 SE MERION CT, PORT SAINT LUCIE, FL 34952-5419
(772) 528-1673
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
11020302
FL
Other
Enumeration date
06/18/2022
Last updated
06/18/2022
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