Blake, Kimberly

Blake, Kimberly is an individual health care provider with primary practice located at 96 Colchester Ave , Burlington VT 05401-1417. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Blake, Kimberly can be contacted via phone (802) 658-0505.

Contact Information

Primary practice address
96 Colchester Ave Burlington VT 05401-1417
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 0420008805 Vermont
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 302048 New York

Profile Details

NPI number 1265480222
LBN Legal business name Blake, Kimberly
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 4th, 2006
Last updated Jan 2nd, 2020 - about 6 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265480222 NPPES
Vermont Other 160050512 RAIL ROAD MEDICARE
Vermont MEDICAID 0VN0812 RAIL ROAD MEDICARE

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