Individual
BLAKE ANDREW EMBREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
423 CENTRAL AVENUE, COLDWATER, MS 38618
(662) 622-7011
Mailing address
423 CENTRAL AVE, COLDWATER, MS 38618-3915
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
902101
MS
Other
Enumeration date
08/03/2017
Last updated
08/03/2017
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