Provider Demographics
NPI:1922826106
Name:BLAKEMORE, ADRIANNE (CD)
Entity type:Individual
Prefix:
First Name:ADRIANNE
Middle Name:
Last Name:BLAKEMORE
Suffix:
Gender:F
Credentials:CD
Other - Prefix:
Other - First Name:ADRIANNE
Other - Middle Name:
Other - Last Name:WOODARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4818 WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63108-1829
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7821 MADISON DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63133-1113
Practice Address - Country:US
Practice Address - Phone:773-816-9536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-27
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula