Individual
MELINDA K BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
6330 DIGITAL WAY, INDIANAPOLIS, IN 46278-1667
(317) 473-6688
Mailing address
6330 DIGITAL WAY, INDIANAPOLIS, IN 46278-1667
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
28194809A
IN
363LF0000X
Family Nurse Practitioner
Primary
71006530A
IN
Other
Enumeration date
08/15/2016
Last updated
12/09/2023
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