Individual provider · Type 1 NPI
Jillian Marie Blake
Acute Care Nurse Practitioner · Boston, MA
NPI number
1114792280
Active
Practice location
55 Fruit St
Boston, MA 02114-2696
Mailing address
12 Cleveland Ave
Wilmington, MA 01887-2865
Other practice locations
- 156 Chester Rd, Derry, NH 03038-5555 · (603) 204-4408
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | NA (MA) |
| Acute Care Nurse Practitioner Primary | 363LA2100X | RN2326798 (MA) |
Acute Care Nurse Practitioner: Definition to come...
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About NPI 1114792280
Jillian Marie Blake's National Provider Identifier is 1114792280, issued on Nov 20, 2023. The primary taxonomy on file is Acute Care Nurse Practitioner (363LA2100X), and the practice location is in Boston, MA. The record was last updated on Jul 17, 2025.