Individual
MR. NATHAN ALLEN BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
920 CHURCH ST N, CONCORD, NC 28025-2927
(704) 403-4235
Mailing address
5025 AIRPORT CENTER PKWY BLDG L, CHARLOTTE, NC 28208-5885
(704) 512-7105
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
191944
NC
Other
Enumeration date
01/03/2014
Last updated
12/29/2017
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