Phyllisa Dawn Blake, RN Valid NPI

Individual provider · Registered Nurse · Chamblee, GA

NPI

1629329453

Type

Individual (Type 1)

Primary specialty

Registered Nurse

Specialty group

Nursing Service Providers

Taxonomy code

163W00000X

License number

RN196553 (GA)

Sex

Female

Sole proprietor

No

Enumerated

2012-09-19

Last updated

2012-09-24