Katherine E Blake, N.P.
Nurse Practitioner, Family in New Bern, NC. Individual provider (NPI-1).
NPI number1912246331
StatusActive
Last updated in NPPESMar 12, 2024
Details
- NPI
- 1912246331
- Entity type
- Individual (NPI-1)
- Name
- Katherine E Blake
- Credential
- N.P.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 5, 2013
- Certification date
- Mar 12, 2024
- Last updated
- Mar 12, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 5019185 | NC | Yes |
| 363LF0000X | Nurse Practitioner, Family | 209009946 | IL | |
| 363LP2300X | Nurse Practitioner, Primary Care | 209009946 | IL |
Practice location
2002 S Glenburnie Rd Ste 100New Bern, NC 28562-5229
Phone 252-631-5188
Mailing address
2002 S Glenburnie Rd Ste 100New Bern, NC 28562-5229
Phone 252-631-5188 · Fax 815-729-1643
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