Individual
JEWEL BLAKE-HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
520 MULLEN CT, LOCUST GROVE, GA 30248-2500
(404) 210-4247
Mailing address
520 MULLEN CT, LOCUST GROVE, GA 30248-2500
(404) 210-4247
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN098388
GA
Other
Enumeration date
06/09/2025
Last updated
06/09/2025
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