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General NPI Number Information
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NPI Number | 1396233490
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Entity Type | Individual
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Provider Name | DORIAN R BLAKE FNP
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Gender | Female
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Dates
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Enumeration Date | 04/25/2018
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Last Update Date | 02/05/2025
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Provider Practice Location Address
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Address Line | 601 E HAMPDEN AVE STE 390
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City | ENGLEWOOD
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State | CO
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Zip | 80113-2796
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Country | US
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Telephone | 228-230-2663
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Fax | 228-546-3257
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Provider Business Mailing Address
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Address Line | 601 E HAMPDEN AVE STE 390
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City | ENGLEWOOD
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State | CO
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Zip | 80113-2796
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Country | US
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Telephone | 720-336-4300
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Fax | 720-833-9145
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 902855
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License Number State | MS
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