Individual
MRS. DANA CROSBY BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
1250 E MARSHALL ST, NEUROLOGY, RICHMOND, VA 23298-5051
(804) 828-7999
(804) 828-1151
Mailing address
PO BOX 91734, RICHMOND, VA 23291-1734
(804) 358-6100
(804) 342-7619
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001117856
VA
363LF0000X
Family Nurse Practitioner
Primary
0024169011
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1629379789
—
VA
Enumeration date
11/05/2010
Last updated
02/03/2014
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