Opal Mullings Blake, NP-C

Nurse Practitioner · Lawrenceville, GA

Individual Active NPI

NPI number 1043629140

Practice location

631 Professional Dr Ste 350
Lawrenceville, GA 30046-3370
Phone
(770) 995-0630
Fax
(770) 995-1555

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NPI record

NPI
1043629140
Entity type
Individual (Type 1)
Enumeration date
August 4, 2014
Last updated
January 4, 2016
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Nurse Practitioner Primary 363L00000X RN 199200 GA
Nurse Practitioner 363L00000X RN199200 GA

Mailing address

631 Professional Dr
Suite 350
Lawrenceville, GA 30046
Phone
(770) 995-0630
Fax
(770) 682-0088

About Opal Blake

Opal Mullings Blake, NP-C is a healthcare provider registered in the NPI registry with the primary taxonomy Nurse Practitioner (code 363L00000X). The practice location is 631 Professional Dr Ste 350, Lawrenceville, GA 30046-3370. The NPI number 1043629140 was assigned on August 4, 2014 and the record was last updated on January 4, 2016.

Opal Blake lists 2 licenses in the registry: #RN 199200 (GA) for Nurse Practitioner; #RN199200 (GA) for Nurse Practitioner. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Opal Mullings Blake, NP-C?

The NPI number is 1043629140.

What is the phone number of Opal Blake?

The phone number listed for the practice location is (770) 995-0630.

Where is Opal Blake located?

631 Professional Dr Ste 350, Lawrenceville, GA 30046-3370.

What is the taxonomy code for Opal Blake?

The primary taxonomy code is 363L00000X – Nurse Practitioner; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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