| Tara Nicole Blake, | |
|
3633 Seneca Trl S, Peterstown, WV 24963-5063 | |
| (304) 994-1490 | |
| Not Available |
| Full Name | Tara Nicole Blake |
|---|---|
| Gender | Female |
| Speciality | Licensed Practical Nurse |
| Location | 3633 Seneca Trl S, Peterstown, West Virginia |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487519898 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 164W00000X | Licensed Practical Nurse | 37492 (West Virginia) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Tara Nicole Blake, 3633 Seneca Trl S, Peterstown, WV 24963-5063 Ph: (304) 994-1490 | Tara Nicole Blake, 3633 Seneca Trl S, Peterstown, WV 24963-5063 Ph: (304) 994-1490 |
Jessica Fisher, LPN Licensed Practical Nurse Medicare: Not Enrolled in Medicare Practice Location: 5414 Ballard Red Sulphur Pkwy, Peterstown, WV 24963 Phone: 304-753-4322 | |
Kimberly Dawn Rhodes, LPN Licensed Practical Nurse Medicare: Not Enrolled in Medicare Practice Location: 5414 Ballard Red Sulphur Pkwy, Peterstown, WV 24963 Phone: 304-793-2628 Fax: 304-936-0155 | |
Mrs. Amanda Michelle Crumpler, Licensed Practical Nurse Medicare: Not Enrolled in Medicare Practice Location: 2869 Seneca Trl S, Peterstown, WV 24963 Phone: 304-753-4336 Fax: 304-753-4097 |