Blake Larose, FNP Valid NPI

Individual provider · Family Nurse Practitioner · Thibodaux, LA

NPI

1366129769

Type

Individual (Type 1)

Primary specialty

Family Nurse Practitioner (Nurse Practitioner)

Specialty group

Physician Assistants & Advanced Practice Nursing Providers

Taxonomy code

363LF0000X

License number

201963 (LA)

Sex

Male

Sole proprietor

No

Enumerated

2023-06-28

Last updated

2023-06-28