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Individual

CALEY ELIZABETH BLAKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
4915 NORTON HEALTHCARE BLVD STE 202, LOUISVILLE, KY 40241-2861
(502) 891-8300
(502) 394-6525
Mailing address
PO BOX 780125, PHILADELPHIA, PA 19178-0125
(804) 922-4844

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110011780
VA
363A00000X
Physician Assistant
PA2847
KY
363A00000X
Physician Assistant
Primary
TC135
KY
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
06/28/2021
Last updated
06/10/2026
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