Blake, Katie Jacqueline

Blake, Katie Jacqueline is an individual health care provider with primary practice located at 494 Gancedo St Sw , Palm Bay FL 32908-1270. She recently has only one registered license in Nursing Service Related Providers / Personal Care Attendant, which is considered as her primary health care specialty. Blake, Katie Jacqueline can be contacted via phone (218) 269-1483.

Contact Information

Primary practice address
494 Gancedo St Sw Palm Bay FL 32908-1270
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Related Providers / Personal Care Attendant 3747P1801X

Profile Details

NPI number 1053934430
LBN Legal business name Blake, Katie Jacqueline
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 20th, 2020
Last updated May 20th, 2020 - about 4 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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