Individual
BRANDI JAY BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
85 DONOHOE DR, HUNTINGTON, WV 25705-8887
(304) 399-3310
Mailing address
4043 ROCKY FORK RD, GLENWOOD, WV 25520-9266
(304) 531-4868
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
114033
WV
Other
Enumeration date
10/10/2022
Last updated
05/16/2024
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