Individual
KAREN E BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
909 VZ COUNTY ROAD 2313, CANTON, TX 75103-4851
(903) 848-4710
(903) 848-9420
Mailing address
909 VZ COUNTY ROAD 2313, CANTON, TX 75103-4851
(903) 848-4710
(903) 848-9420
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
741293
TX
164X00000X
Licensed Vocational Nurse
Primary
112553
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1002581
—
TX
Enumeration date
07/19/2007
Last updated
07/19/2007
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