Individual
DANIELLE BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
4100 JOHN R ST, DETROIT, MI 48201-2013
(800) 527-6266
(313) 576-8381
Mailing address
1511 N ALEXANDER AVE, ROYAL OAK, MI 48067-3632
(269) 720-4962
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4704318244
MI
363LF0000X
Family Nurse Practitioner
Primary
4704318244
MI
Other
Enumeration date
09/18/2020
Last updated
06/17/2024
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