Individual
KATHERINE E BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
2002 S GLENBURNIE RD STE 100, NEW BERN, NC 28562-5229
(252) 631-5188
Mailing address
2002 S GLENBURNIE RD STE 100, NEW BERN, NC 28562-5229
(252) 631-5188
(815) 729-1643
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
209009946
IL
363LF0000X
Family Nurse Practitioner
Primary
5019185
NC
363LP2300X
Primary Care Nurse Practitioner
209009946
IL
Other
Enumeration date
02/05/2013
Last updated
03/12/2024
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