National Provider Identifier

Kathleen Susan Blake

Kathleen Susan Blake is listed in the NPPES registry with a primary specialty of Licensed Practical Nurse in Livonia, NY and a listed phone number of (401) 316-2777.

NPI 1841032745Livonia, NYLicensed Practical Nurse

Profile Overview

NPI
1841032745
Provider Type
Individual
Primary Specialty
Licensed Practical Nurse
Enumeration Date
June 11, 2024
Last Updated
June 11, 2024

Practice Location

  • 5988 Price RD
  • Livonia, NY 14487-9672

Phone: (401) 316-2777

Specialties

  • Licensed Practical Nurse (164W00000X)
Full Record
NPI
1841032745
Entity Type
Individual
Last Name
Blake
First Name
Kathleen
Middle Name
Susan
Mailing Street Address
5988 Price RD
Mailing City
Livonia
Mailing State
NY
Mailing ZIP Code
14487-9672
Mailing Country
US
Mailing Phone
(401) 316-2777
Practice Street Address
5988 Price RD
Practice City
Livonia
Practice State
NY
Practice ZIP Code
14487-9672
Practice Country
US
Practice Phone
(401) 316-2777
Enumeration Date
June 11, 2024
Last Updated
June 11, 2024
Sex
Female
Sole Proprietor
Yes
Certification Date
June 11, 2024
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Licensed Practical Nurse (164W00000X)