National Provider Identifier Database

KIMBERLY L BLAKE, FNP-C – NPI #1689971749
Family


Contact Information

KIMBERLY L BLAKE, FNP-C
1125 SKYLINE DR
CONWAY, AR72032-6657
Phone: 501-358-6120
Fax: 501-358-6268
Website:
Specialty Taxonomy Code
* Family 363LF0000X

* Indicates primary specialty

NPI Profile & details for KIMBERLY L BLAKE

NPI Number 1689971749
Credentials FNP-C (Family Nurse Practitioner, Certified)
Entity Individual
Enumeration date 02/24/2011
Last updated 05/10/2017 - About 9 years ago
Sole proprietor1 No
Identifiers
  • AR License #: A03482 ANP
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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