MEDICARE: MARGARET JANIS BLAKE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	126353	OH

General Provider Information

NPI Number	:	1578419289
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARGARET JANIS BLAKE

Provider Business Mailing Address
First Line	:	201 HOSPITAL DR
Second Line	:
City	:	DOVER
State	:	OH
Zip	:	44622-2058
Country	:	US
Telephone Number	:	330-343-6631
Fax Number	:	330-343-3150

Provider Business Practice Location Address
First Line	:	201 HOSPITAL DR
Second Line	:
City	:	DOVER
State	:	OH
Zip	:	44622-2058
Country	:	US
Telephone Number	:	330-343-6631
Fax Number	:	330-343-3150

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/05/2026
Last Update Date	:	03/05/2026

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Directions to “ MARGARET JANIS BLAKE ” Practice Location

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