Individual
BLAKE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
RN0000161004
TN
363LP2300X
Primary Care Nurse Practitioner
Primary
24523
TN
Other
Enumeration date
10/19/2009
Last updated
08/29/2018
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