Individual
JILLIAN MARIE BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2696
(617) 726-2000
Mailing address
12 CLEVELAND AVE, WILMINGTON, MA 01887-2865
(603) 204-4208
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
NA
MA
363LA2100X
Acute Care Nurse Practitioner
Primary
RN2326798
MA
Other
Enumeration date
11/20/2023
Last updated
07/17/2025
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