Individual
TRUDY-ANN BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4740 PORTOFINO WAY APT 309, WEST PALM BEACH, FL 33409-8181
(201) 212-8075
Mailing address
4740 PORTOFINO WAY APT 309, WEST PALM BEACH, FL 33409-8181
(201) 212-8075
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5232348
FL
Other
Enumeration date
04/10/2020
Last updated
09/29/2020
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