ANDREA BLAKE ARNP NPI 1174637748

NPI Information

NPI: 1174637748
Provider Name: ANDREA BLAKE, ARNP
Classification: Nurse Practitioner - 363LG0600X
Entity Type: Individual

Specialization: Gerontology

PECOS Registration: Yes

Address:
1111 6TH AVE
EAST TOWER SUITE A100
DES MOINES, IA
ZIP 50314
Phone: (515) 358-0011
Get Directions

Andrea Blake, ARNP is a gerontology nurse practitioner in Des Moines, IA. Andrea Blake, ARNP NPI is 1174637748. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1111 6TH AVE
EAST TOWER SUITE A100
DES MOINES, IA
ZIP 50314-610
Phone: (515) 358-0011

The NPI 1174637748 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/19/2006 and was last updated on 9/5/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LG0600X	Nurse Practitioner	Gerontology	R162244	MARYLAND	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	Q61210	MEDICARE UPIN	IOWA
2	0485813	MEDICAID	IOWA
3	I16796	MEDICARE ID-TYPE UNSPECIFIED	IOWA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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