Individual provider · Type 1 NPI

Danielle Rebecca Blake

Nurse Practitioner · Fenton, MO

NPI number 1265900450 Active

Practice location

1055 Bowles Ave Ste 200
Fenton, MO 63026-2308

Mailing address

PO Box 955534
St. Louis, MO 63195-5534

Specialties and licenses

TaxonomyCodeLicense
Registered Nurse 163W00000X2013025839 (MO)
Nurse Practitioner Primary 363L00000X2018011508 (MO)

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 1265900450

Danielle Rebecca Blake's National Provider Identifier is 1265900450, issued on Nov 6, 2018. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Fenton, MO. The record was last updated on Dec 18, 2024.