Individual
MADELINE ELYCE BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
153 GORDON ST, CULLODEN, WV 25510-7436
(304) 550-9610
Mailing address
153 GORDON ST, CULLODEN, WV 25510-7436
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
116163
WV
Other
Enumeration date
01/08/2026
Last updated
01/08/2026
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