Blake Lawrence Valid NPI

Individual provider · Nurse Practitioner · Pleasant Grove, UT

NPI

1902314289

Type

Individual (Type 1)

Primary specialty

Nurse Practitioner

Specialty group

Physician Assistants & Advanced Practice Nursing Providers

Taxonomy code

363L00000X

License number

12078815-4405 (UT)

Sex

Male

Sole proprietor

Yes

Enumerated

2018-01-20

Last updated

2024-01-26