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Individual

TEMEKIA SHAUNTRICE BLAKELY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
11653 COUNTY ROAD 7, TROY, AL 36081-7157
(334) 300-2819
Mailing address
11653 COUNTY ROAD 7, TROY, AL 36081-7157
(334) 300-2819

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1-1414215
AL
363LA2200X
Adult Health Nurse Practitioner
Primary
AG0223047
AL
363LG0600X
Gerontology Nurse Practitioner
AG0223047
AL

Other

Enumeration date
10/09/2023
Last updated
10/09/2023
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