Provider Demographics
NPI:1154759520
Name:BLAKNEY, FRIEDA
Entity type:Individual
Prefix:
First Name:FRIEDA
Middle Name:
Last Name:BLAKNEY
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 1:851 FRANCONIA VILLAGE
Mailing Address - Street 2:
Mailing Address - City:ALICEVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35442-1014
Mailing Address - Country:US
Mailing Address - Phone:205-373-8333
Mailing Address - Fax:205-373-8845
Practice Address - Street 1:851 FRANCONIA VILLAGE
Practice Address - Street 2:
Practice Address - City:ALICEVILLE
Practice Address - State:AL
Practice Address - Zip Code:35442-1014
Practice Address - Country:US
Practice Address - Phone:205-373-8333
Practice Address - Fax:205-373-8845
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-23
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor