Individual
JILL BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
502 STUDENT HEALTH CTR, UNIVERSITY PARK, PA 16802-2129
(814) 865-6555
(814) 863-8464
Mailing address
502 STUDENT HEALTH CENTER, PENN STATE UNIVERSITY, UNIVERSITY PARK, PA 16802
(814) 865-6555
(814) 863-8464
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN255327L
PA
Other
Enumeration date
03/27/2015
Last updated
03/27/2015
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