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Individual

MS. LORI ANN BLAKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, BC, FNP

Contact information

Practice address
4C NORTH AVE STE 403, BEL AIR, MD 21014-2333
(443) 567-6320
(443) 327-4951
Mailing address
4C NORTH AVE STE 403, BEL AIR, MD 21014-2333
(443) 567-6320
(443) 327-4951

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
155922
MO
363L00000X
Nurse Practitioner
AP4625
AZ
363LF0000X
Family Nurse Practitioner
Primary
1022167
TX
363LF0000X
Family Nurse Practitioner
R270237
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200331470A
KS
05
223521800
MD
05
427366802
MO
05
734594
AZ
Enumeration date
04/26/2006
Last updated
06/06/2025
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