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Individual

CASEY DANIEL BLONDE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RN

Contact information

Practice address
4001 E BASELINE RD STE 204, GILBERT, AZ 85234-2743
(480) 565-6440
Mailing address
4101 S DEW DROP CT, GILBERT, AZ 85297-9655
(347) 524-5220

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN195764
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
302097
AZ

Other

Enumeration date
08/24/2021
Last updated
01/10/2024
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