MS. CYNTHIA J. BLAKE (NPI# 1861463994) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1861463994 |
Entity Type | Individual |
Full Name | MS. CYNTHIA J. BLAKE |
Credential | APRN,BC |
Practice Address |
600 Macinnes Dr Houghton MI 49931-1144 |
Mailing Address |
894 Campus Dr Ste B Hancock MI 49930-1644 |
Practice Telephone | 9064831860 |
Practice Fax Number | 9064831270 |
Mailing Telephone | 9064831445 |
Mailing Fax Number | 9064831122 |
Enumeration Date | 2006-01-27 |
Last Update Date | 2016-08-25 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
SP008734 | PA | Physician Assistants & Advanced Practice Nursing Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1972168326 | Cynthia J. Blake | Social Worker | Pascack Mental Health, 114 Kinderkamack Road, Park Ridge, NJ 07656 | 2019-05-01 |
1821337247 | Cynthia Blake | Counselor | 105 E Castellano Dr Ste C, El Paso, TX 79912-6436 | 2013-02-05 |
1558772814 | Cynthia Salmon Blake | Licensed Practical Nurse | 4020 Wake Forest Rd, Suite 201, Raleigh, NC 27609-6866 | 2014-05-08 |
1538373576 | Cynthia E Blake | Occupational Therapy Assistant | 1422 San Marco Blvd, Jacksonville, FL 32207-8536 | 2007-05-09 |
Street Address |
600 MACINNES DR |
City | HOUGHTON |
State | MI |
Zip Code | 49931-1144 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1487157103 | Monica Anne Aho | Physical Therapist | 600 Macinnes Dr, Houghton, MI 49931-1144 | 2018-03-09 |
1629592647 | Stephanie Ann Bonenfant | Physician Assistant | 600 Macinnes Dr, Houghton, MI 49931-1144 | 2017-08-01 |
1619304615 | Portage Physician Practices Inc | Clinic/Center | 600 Macinnes Dr, Houghton, MI 49931-1144 | 2013-10-04 |
1902126998 | Todd W Anderson | Family Medicine | 600 Macinnes Dr, Houghton, MI 49931-1144 | 2010-06-02 |
1619296894 | Paul Dennis Peterson | Pharmacist | 600 Macinnes Dr, Houghton, MI 49931-1144 | 2010-05-27 |
1063748770 | Portage Health Inc. | Family Medicine | 600 Macinnes Dr, Houghton, MI 49931-1144 | 2009-10-30 |
1891942769 | Melissa A Vertin | Physician Assistant | 600 Macinnes Dr, Houghton, MI 49931-1144 | 2008-08-22 |
1093979700 | Zachariah Matthew Deyoung | Family Medicine | 600 Macinnes Dr, Houghton, MI 49931-1144 | 2008-07-11 |
1982801569 | Karen Marie Deyoung | Family Medicine | 600 Macinnes Dr, Houghton, MI 49931-1144 | 2007-06-28 |
1356475289 | Annette Kristiin Keranen | Physical Therapy Assistant | 600 Macinnes Dr, Houghton, MI 49931-1144 | 2007-03-15 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962053447 | Meghan Lawler Immel | Counselor | 47431 St. Hwy M26 Unit 1, Suite 2, Houghton, MI 49931 | 2019-09-25 |
1205495710 | Public Counseling Services, LLC | Counselor | 47431 Hwy M26 Unit 1, Suite 2, Houghton, MI 49931 | 2019-06-08 |
1679047278 | Margiejo D Packham | Registered Nurse | 109 W Memorial Dr, Hancock, MI 49931 | 2019-01-16 |
1487150165 | Taylor Lee Douglas | Optometrist | 900 W Mem Dr, Houghton, MI 49931 | 2018-04-02 |
1033640867 | Larry Binoniemi | Pharmacist | 995 Razoback Dr, Houghton, MI 49931 | 2017-03-23 |
1013247972 | Portage Health Inc | General Practice | 921 W Sharon Ave., Houghton, MI 49931 | 2009-12-28 |
1508001629 | Aspirus Keweenaw | General Practice | 900 Memorial Drive, Houghton, MI 49931 | 2008-12-03 |
1306027057 | Gary Kilpela | Psychologist | 301 West Lake Ave., Suite 2, Houghton, MI 49931 | 2007-11-23 |
1811186455 | Baraga-houghton-keweenaw Child Development Board | Public Health or Welfare | 700 Park Avenue, Houghton, MI 49931 | 2007-10-19 |
1922294107 | Diane Sue Johnson | Registered Nurse | 901 West Memorial Drive, Houghton, MI 49931 | 2007-09-20 |
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Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952400889 | Sharon E Thornton | Nurse Practitioner | 9864 Luckey Dr, Houghton, NY 14744-8706 | 2006-09-21 |
1477955276 | Teri Reevs | Nurse Practitioner | 1000 Cedar St, Houghton, MI 49931-1978 | 2014-09-23 |
1013240886 | Beki Asti | Nurse Practitioner | 901 Memorial Rd, Houghton, MI 49931-2475 | 2009-09-11 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1659972339 | Zeinab Berjaoui | Nurse Practitioner | 11496 Newbern Dr, Warren, MI 48093-2613 | 2020-11-08 |
1134720899 | Whitney Ashton Mervau | Nurse Practitioner | 3836 Haven Hill Ln, Williamsburg, MI 49690-9536 | 2020-11-07 |
1063013837 | Amy Lynn Wadsworth | Nurse Practitioner | 9259 Chambord Dr, Ypsilanti, MI 48197-9281 | 2020-11-06 |
1821699844 | Michelle Daldine | Nurse Practitioner | 38481 Gail St, Clinton Township, MI 48036-1823 | 2020-11-05 |
1710588876 | Coty Cole | Nurse Practitioner | 2065 South Center Rd, Ste A, Burton, MI 48519 | 2020-11-05 |
1205437175 | Michelle Jo Whitesel | Nurse Practitioner | 5861 Shadow Pines Ct, Howell, MI 48843-7130 | 2020-11-05 |
1326649617 | Melinda Lee Hawley | Nurse Practitioner | 4019 Stark Dr, West Branch, MI 48661-9633 | 2020-11-04 |
1720689193 | Mohammed Louthfur Rahman | Nurse Practitioner | Hoover Internal Medicine Pllc, 2930 Holbrook St, Hamtramck, MI 48212 | 2020-11-03 |
1619578234 | Devon Kruger | Nurse Practitioner | 4612 W David Hwy, Saranac, MI 48881-9740 | 2020-11-02 |
1760083208 | Ramonna Van Alstine | Nurse Practitioner | 13932 Fox Ridge Ln, Allenton, MI 48002-4525 | 2020-11-02 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.