Individual
BLAKE MICHAEL SIBLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
8585 PICARDY AVE, BATON ROUGE, LA 70809-3748
(225) 763-4764
(225) 763-4549
Mailing address
7373 PERKINS RD, BATON ROUGE, LA 70808-4373
(225) 246-9790
(225) 246-9160
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
230761
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2620746
—
LA
Enumeration date
06/23/2023
Last updated
09/19/2023
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