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Individual

CHERYL NADINE BLAKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
707 E PRIEN LAKE RD STE A, LAKE CHARLES, LA 70601-8788
(337) 475-3200
(337) 475-3222
Mailing address
3560 W CABELLA DR, SULPHUR, LA 70665-8774
(337) 244-4622

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
203900
LA

Other

Enumeration date
05/08/2019
Last updated
05/08/2019
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