Individual
KATHERINE A BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN BC
Contact information
Practice address
55 PLEASANT STREET, NEWBURY PORT, MA 01950
(978) 462-0302
(978) 499-0226
Mailing address
55 PLEASANT STREET, NEWBURY PORT, MA 01950
(978) 462-0302
(978) 499-0226
Taxonomy
Speciality
Code
Description
License number
State
364S00000X
Clinical Nurse Specialist
Primary
104897
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
708967
TUFTS
MA
01
—
PN0059
BCBS
MA
Enumeration date
10/05/2006
Last updated
07/08/2007
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