Individual provider · Type 1 NPI
Ryan Blake Province, PharmD
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist · Fort Leavenworth, KS
NPI number
1134592454
Active
Practice location
550 Pope Ave
Fort Leavenworth, KS 66027-2332
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist Primary | 1835P0018X | 1-16504 (KS) |
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist: Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management.
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About NPI 1134592454
Ryan Blake Province, PharmD's National Provider Identifier is 1134592454, issued on Nov 9, 2015. The primary taxonomy on file is Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (1835P0018X), and the practice location is in Fort Leavenworth, KS. The record was last updated on Jul 8, 2026.