Individual provider · Type 1 NPI

Shauna Rochelle Blake, FNP

Family Nurse Practitioner · New London, CT

NPI number 1568377604 Active

Practice location

1 Shaws Cv
New London, CT 06320-4902

Call (860) 447-8304 Map

Fax (860) 447-8720

Mailing address

19 Grand St
Middletown, CT 06457-2705

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000X18119 (CT)

Family Nurse Practitioner: Definition to come...

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About NPI 1568377604

Shauna Rochelle Blake, FNP's National Provider Identifier is 1568377604, issued on Aug 14, 2026. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in New London, CT. The record was last updated on Aug 20, 2026.