Individual
BLAKE ANDREW NIZINSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5662 SCREAMING EAGLE BLVD, FORT CAMPBELL, KY 42223-5403
(270) 798-7111
Mailing address
23 CAMELTOWN HILL RD, DANVILLE, PA 17821-9589
(570) 492-2672
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/23/2026
Last updated
06/23/2026
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