Individual
BLAKE PEDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3201 1ST ST, EMMETSBURG, IA 50536-2516
(712) 852-5500
Mailing address
3201 1ST ST, EMMETSBURG, IA 50536-2516
(712) 852-5500
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
G188690
IA
Other
Enumeration date
01/22/2026
Last updated
01/22/2026
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