Blake, Kathleen
Blake, Kathleen is an individual health care provider with primary practice located at 502 Elm St Ne , Albuquerque NM 87102-2512. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology. Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology is her primary health care specialty. Blake, Kathleen can be contacted via phone (505) 841-1000.Contact Information
Primary practice address
502 Elm St Ne
Albuquerque NM 87102-2512
Phone: (505) 841-1000
Fax: (505) 843-2853
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 88-7 | New Mexico |
Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology | 207RC0001X | 88-7 | New Mexico |
Profile Details
NPI number | 1649272808 |
---|---|
LBN Legal business name | Blake, Kathleen |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 1st, 2005 |
Last updated | Jan 5th, 2010 - about 15 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 | 1649272808 | NPPES |
New Mexico | MEDICAID | 03194 |
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