Individual
AMY SUSAN BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
680 BLAIR MILL RD, HORSHAM, PA 19044-2223
(302) 304-6341
Mailing address
129 CAMBRIDGE RD, LANDENBERG, PA 19350-1304
(302) 757-0861
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
LG-0000384
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013978535
—
DE
Enumeration date
04/01/2006
Last updated
08/17/2020
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