Individual provider · Type 1 NPI
Tara Nicole Blake
Licensed Practical Nurse · Peterstown, WV
NPI number
1487519898
Active
Practice location
3633 Seneca Trl S
Peterstown, WV 24963-5063
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Licensed Practical Nurse Primary | 164W00000X | 37492 (WV) |
Licensed Practical Nurse: An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
Other licensed practical nurse providers in Peterstown
About NPI 1487519898
Tara Nicole Blake's National Provider Identifier is 1487519898, issued on Dec 17, 2025. The primary taxonomy on file is Licensed Practical Nurse (164W00000X), and the practice location is in Peterstown, WV. The record was last updated on Dec 17, 2025.