Individual
JESSIKA N BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1747 BAPTIST CLAY DR STE 230, FLEMING ISLAND, FL 32003-8505
(904) 592-1068
(904) 390-7386
Mailing address
PO BOX 41516, JACKSONVILLE, FL 32203-1516
(904) 202-5111
(904) 391-5836
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN11011711
FL
363LF0000X
Family Nurse Practitioner
11011711
FL
363LF0000X
Family Nurse Practitioner
APRN11011711
FL
Other
Enumeration date
04/21/2021
Last updated
05/10/2021
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