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Individual

BLAKE STAGNI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-3000
Mailing address
617 CLARE CT APT B, NEW ORLEANS, LA 70124-1763
(985) 859-0802

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP08384
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
09050015
MS
05
2400037
LA
Enumeration date
07/30/2015
Last updated
10/06/2015
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