Blake Morrow

Individual provider Active NPI Licensed Practical Nurse · Black Hawk, CO

NPI 1235947508 · NPPES record last updated Dec 19, 2024

Key facts

NPI
1235947508
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
PM.0338559 (CO)
Practice address
515 Coyote Cir
Black Hawk, CO 80422-8711
Phone
(903) 720-2574
NPI assigned
Dec 19, 2024
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PM.0338559COMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PM.0338559 CO Yes

Addresses

Primary practice location

515 Coyote Cir
Black Hawk, CO 80422-8711

Mailing address

515 Coyote Cir
Black Hawk, CO 80422-8711

Other providers in Black Hawk, CO

All providers in Black Hawk, CO · Licensed Practical Nurse in Colorado

Sources for this page

Verify at the official NPI Registry.