Individual
MISS MEGAN BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
3525 RESOURCE DR, RANDALLSTOWN, MD 21133-4733
(410) 887-0600
Mailing address
1212 WALTERS AVE, BALTIMORE, MD 21239-2826
(443) 600-5169
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
220071
MD
Other
Enumeration date
11/22/2016
Last updated
11/22/2016
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