Individual provider · Type 1 NPI
Jordan Blake
Student in an Organized Health Care Education/Training Program · Garner, NC
NPI number
1467840645
Active
Practice location
1700 Lakeside Dr
Garner, NC 27529-3845
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Athletic Trainer | 2255A2300X | None listed |
| Student in an Organized Health Care Education/Training Program Primary | 390200000X | None listed |
Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
About NPI 1467840645
Jordan Blake's National Provider Identifier is 1467840645, issued on Dec 22, 2014. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Garner, NC. The record was last updated on Dec 23, 2014.