Individual
ANDREW T BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
2350 CLEVELAND AVE N, ROSEVILLE, MN 55113-2701
(507) 850-1100
(651) 493-4247
Mailing address
8444 N 90TH ST STE 100, SCOTTSDALE, AZ 85258-4437
(602) 248-8886
(480) 687-7361
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2499974
MN
Other
Enumeration date
07/23/2026
Last updated
07/23/2026
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