Individual
MRS. ANITRA BLAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
620 MAGNOLIA RIDGE RD, BOUTTE, LA 70039-3223
(504) 915-4928
Mailing address
PO BOX 6856, METAIRIE, LA 70009-6856
(504) 915-4928
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
120569
LA
Other
Enumeration date
02/15/2017
Last updated
02/15/2017
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