Individual provider · Type 1 NPI

Blake Wollam

Family Nurse Practitioner · Mentor, OH

NPI number 1013643048 Active

Practice location

7060 Wayside Dr
Mentor, OH 44060-6527

Mailing address

2157 Lakeland Ave
Lakewood, OH 44107-5715

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000XAPRN.CNP.0031396 (OH)

Family Nurse Practitioner: Definition to come...

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About NPI 1013643048

Blake Wollam's National Provider Identifier is 1013643048, issued on Aug 1, 2022. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Mentor, OH. The record was last updated on Aug 1, 2022.