Individual
OLIVIA KEELIN BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
169 N PENNSYLVANIA AVE, WILKES BARRE, PA 18701-3603
(570) 346-8147
(570) 230-0013
Mailing address
169 N PENNSYLVANIA AVE, WILKES BARRE, PA 18701-3603
(570) 346-8147
(570) 230-0013
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP033283
PA
Other
Enumeration date
09/08/2025
Last updated
09/08/2025
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