Blake, Andrea
Blake, Andrea is an individual health care provider with primary practice located at 1111 6Th Ave East Tower Suite A100, Des Moines IA 50314-2610. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Gerontology, which is considered as her primary health care specialty. Blake, Andrea can be contacted via phone (515) 358-0011.Contact Information
Primary practice address
1111 6Th Ave East Tower Suite A100
Des Moines IA 50314-2610
Phone: (515) 358-0011
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Gerontology | 363LG0600X | R162244 | Maryland |
Profile Details
| NPI number | 1174637748 |
|---|---|
| LBN Legal business name | Blake, Andrea |
| Credentials | ARNP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 19th, 2006 |
| Last updated | Sep 5th, 2008 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174637748 | NPPES |
| Iowa | MEDICAID | 0485813 |
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