Individual
GISELA BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
112 ARGUS LN STE A, MOORESVILLE, NC 28117-9270
(336) 406-9207
Mailing address
112 ARGUS LN STE A, MOORESVILLE, NC 28117-9270
(336) 406-9207
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F0117020
NC
Other
Enumeration date
02/02/2017
Last updated
04/13/2018
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