National Provider Identifier
Traci A Blake, RN
Traci A Blake, RN is listed in the NPPES registry with a primary specialty of Community Health Registered Nurse in Canisteo, NY and a listed phone number of (607) 968-4125.
Profile Overview
- NPI
- 1093385759
- Provider Type
- Individual
- Primary Specialty
- Community Health Registered Nurse
- Enumeration Date
- June 25, 2021
- Last Updated
- June 25, 2021
Practice Location
- 5023 Bush Hill RD
- Canisteo, NY 14823-9675
Phone: (607) 968-4125
Specialties
- Community Health Registered Nurse (163WC1500X)
Full Record
- NPI
- 1093385759
- Entity Type
- Individual
- Last Name
- Blake
- First Name
- Traci
- Middle Name
- A
- Credential
- RN
- Mailing Street Address
- 5023 Bush Hill RD
- Mailing City
- Canisteo
- Mailing State
- NY
- Mailing ZIP Code
- 14823-9675
- Mailing Country
- US
- Mailing Phone
- (607) 968-4125
- Practice Street Address
- 5023 Bush Hill RD
- Practice City
- Canisteo
- Practice State
- NY
- Practice ZIP Code
- 14823-9675
- Practice Country
- US
- Practice Phone
- (607) 968-4125
- Enumeration Date
- June 25, 2021
- Last Updated
- June 25, 2021
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- June 25, 2021
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Community Health Registered Nurse (163WC1500X)