Individual
BLAKE A STEVENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
327 MEDICAL PARK DR, BRIDGEPORT, WV 26330-9006
(681) 342-1000
Mailing address
PO BOX 6209, WHEELING, WV 26003-0714
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
71616
WV
Other
Enumeration date
10/02/2007
Last updated
08/19/2011
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