Individual
NELL V BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
500 UNIVERSITY DR, HERSHEY, PA 17033-2360
(800) 233-4082
Mailing address
PO BOX 854, MC A410, HERSHEY, PA 17033-0854
(800) 233-4082
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC004330R
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016592660007
—
PA
Enumeration date
04/17/2006
Last updated
09/18/2009
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