MEDICARE: BLAKE JONES NP

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	363L00000X	Nurse Practitioner	0040177	OH

General Provider Information

NPI Number	:	1700757986
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BLAKE JONES NP

Provider Business Mailing Address
First Line	:	6624 PLEASANT ST
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45227-4244
Country	:	US
Telephone Number	:	419-560-2638
Fax Number	:	513-995-2432

Provider Business Practice Location Address
First Line	:	6624 PLEASANT ST
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45227-4244
Country	:	US
Telephone Number	:	419-560-2638
Fax Number	:	513-995-2432

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

Provider Enumeration Date	:	09/12/2025
Last Update Date	:	09/12/2025

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