Individual
BLAKE BURK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4605 E ELWOOD ST STE 500, PHOENIX, AZ 85040-1978
(480) 256-1518
(480) 304-3446
Mailing address
4605 E ELWOOD ST STE 500, PHOENIX, AZ 85040-1978
(480) 256-1518
(480) 304-3446
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN9494883
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
10041275
OR
367500000X
Certified Registered Nurse Anesthetist
301627
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
301627
CRNA LICENSE
AZ
01
—
RN9494883
RN LICENSE
FL
Enumeration date
07/12/2023
Last updated
07/20/2026
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