Most Relevant Information
Provider Data
| NPI Number: | 1003381641 |
| Provider Name: | ALAYNA MARIE BLAZAKIS CRNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363L00000X |
| Specialty: | Nurse Practitioner |
| License Number: | R191300 |
Most Important Dates
| Enumeration Date: | 10/10/2018 |
| Last Updated: | 10/10/2018 |
Provider Practice Location
5601 LOCH RAVEN BLVD
BALTIMORE
MD
212392945
Practice Location Phone/Fax
| Phone: | 4434444275 |
| Fax: | 4434444276 |
Provider Mailing Location
2824 ONTARIO AVE
BALTIMORE
MD
212341111
Provider Mailing Phone/Fax
| Phone: | 4109358984 |
| Fax: |