Individual
ANDREW ELLIOTT BLAKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
133 ROUTE 3, DEDEDO, GU 96929-6911
(671) 645-5500
(671) 645-5615
Mailing address
202 HILTON RD UNIT 12, TAMUNING, GU 96913-4097
(671) 987-1542
(671) 969-2946
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
827646
TX
163WG0000X
General Practice Registered Nurse
RE2535
GU
363LF0000X
Family Nurse Practitioner
AP139003
TX
363LF0000X
Family Nurse Practitioner
Primary
NP0189
GU
Other
Enumeration date
09/14/2018
Last updated
01/25/2024
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