Blake, Mandy

Blake, Mandy is an individual health care provider with primary practice located at 129 Woodson St , Salisbury NC 28144-3255. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics. Physician Assistants & Advanced Practice Nursing Providers / Pediatrics is her primary health care specialty. Blake, Mandy can be contacted via phone (704) 636-5576.

Contact Information

Primary practice address
129 Woodson St Salisbury NC 28144-3255
Phone: (704) 636-5576
Fax: (704) 216-2011
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 5006329 North Carolina
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 5006329 North Carolina

Profile Details

NPI number 1114359726
LBN Legal business name Blake, Mandy
Credentials Pediatric Nurse Practitioner (PNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 6th, 2013
Last updated Aug 6th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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