Individual
DR. CASEY JEAN BLAKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
4221 FORT HENRY DR, KINGSPORT, TN 37663-2227
(423) 239-9191
Mailing address
601 POPLAR GROVE RD, KINGSPORT, TN 37664-5749
(618) 841-8858
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
47054
TN
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
022364
KY
Other
Enumeration date
09/15/2021
Last updated
07/25/2023
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