Individual provider · Type 1 NPI

Opal Mullings Blake, NP-C

Nurse Practitioner · Lawrenceville, GA

NPI number 1043629140 Active

Practice location

631 Professional Dr Ste 350
Lawrenceville, GA 30046-3370

Call (770) 995-0630 Map

Fax (770) 995-1555

Mailing address

631 Professional Dr, Suite 350
Lawrenceville, GA 30046

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000XRN 199200 (GA)
Nurse Practitioner 363L00000XRN199200 (GA)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1043629140

Opal Mullings Blake, NP-C's National Provider Identifier is 1043629140, issued on Aug 4, 2014. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Lawrenceville, GA. The record was last updated on Jan 4, 2016.