Individual
MARY L. BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP-C
Contact information
Practice address
2936 CALDWELL RIDGE PKWY, CHARLOTTE, NC 28213-5888
(704) 578-8041
Mailing address
2936 CALDWELL RIDGE PKWY, CHARLOTTE, NC 28213-5888
(704) 578-8041
(704) 368-8415
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
5005601
NC
Other
Enumeration date
04/26/2012
Last updated
08/28/2025
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