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General NPI Number Information
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NPI Number | 1730519729
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Entity Type | Individual
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Provider Name | BLAKE ALAN WHEELER TELEMETRY TECH., CNA
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Gender | Male
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Dates
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Enumeration Date | 11/12/2013
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Last Update Date | 11/12/2013
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Provider Practice Location Address
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Address Line | 7701 FLOURISH SPRINGS ST
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City | LAS VEGAS
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State | NV
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Zip | 89131-8212
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Country | US
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Telephone | 702-372-8963
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Fax |
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Provider Business Mailing Address
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Address Line | 7701 FLOURISH SPRINGS ST
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City | LAS VEGAS
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State | NV
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Zip | 89131-8212
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Country | US
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Telephone | 702-372-8963
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374700000X
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Taxonomy Name | Technician
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License Number |
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | CNA027667
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License Number State | NV
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