Provider Demographics
NPI:1831810589
Name:THOWSON, BLAKE ELIZABETH
Entity type:Individual
Prefix:
First Name:BLAKE
Middle Name:ELIZABETH
Last Name:THOWSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:873 W CALLE VALENCIANA
Mailing Address - Street 2:
Mailing Address - City:SAHUARITA
Mailing Address - State:AZ
Mailing Address - Zip Code:85629-8201
Mailing Address - Country:US
Mailing Address - Phone:520-873-7730
Mailing Address - Fax:
Practice Address - Street 1:873 W CALLE VALENCIANA
Practice Address - Street 2:
Practice Address - City:SAHUARITA
Practice Address - State:AZ
Practice Address - Zip Code:85629-8201
Practice Address - Country:US
Practice Address - Phone:520-873-7730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-09
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ222024163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse