Blake, Lori Ann
Blake, Lori Ann is an individual health care provider with primary practice located at 4C North Ave Ste 403 , Bel Air MD 21014-2333. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Blake, Lori Ann can be contacted via phone (443) 567-6320.Contact Information
Primary practice address
4C North Ave Ste 403
Bel Air MD 21014-2333
Phone: (443) 567-6320
Fax: (443) 327-4951
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | AP4625 | Arizona |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 155922 | Missouri |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | R270237 | Maryland |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 1022167 | Texas |
Profile Details
| NPI number | 1255397220 |
|---|---|
| LBN Legal business name | Blake, Lori Ann |
| Credentials | RN, BC, FNP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 26th, 2006 |
| Last updated | Jun 6th, 2025 - about last year |
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 | 1255397220 | NPPES |
| Missouri | MEDICAID | 427366802 | |
| Missouri | MEDICAID | 200331470A | |
| Missouri | MEDICAID | 734594 | |
| Missouri | MEDICAID | 223521800 |
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