Individual
JOAN BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN APRN ACNPC-AG
Contact information
Practice address
2551 GREENWOOD RD STE 410, SHREVEPORT, LA 71103-3989
(318) 621-2929
(318) 621-2930
Mailing address
2551 GREENWOOD RD STE 410, SHREVEPORT, LA 71103-3989
(318) 621-2929
(318) 621-2930
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
237621
LA
Other
Enumeration date
10/11/2024
Last updated
11/07/2024
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