LEAH JANINE BLAKE
Individual Provider (NPI-1)
Active
Hospitalist
Provider Information
- NPI Number
1558757724- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 9850 W ST LUKES DR, NAMPA, ID, 836877912
- Phone
- (208) 205-7282
- Fax
- (208) 205-7591
Specialties & Taxonomies
Hospitalist
License: MT #100092
Hospitalist
License: CO #CDRH.0062081
Student in an Organized Health Care Education/Training Program
Hospitalist
Primary License: ID #OC-0451
All Addresses
MAILING
190 E BANNOCK ST
BOISE, ID, 837126241