Jessica Blake, is a
Nurse Practitioner based in Stanley, Kansas. Jessica Blake is licensed to practice in Kansas (license number 53-76586) and her current practice location is
15101 Glenwood Ave, Stanley, Kansas. She can be reached at her office (for appointments etc.) via phone at
(913) 681-8866.
NPI number for Jessica Blake is 1477955755 and her current mailing address is 15101 Glenwood Ave, Stanley, Kansas. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1477955755.
Provider's Profile
Full Name | Jessica Blake |
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Gender | Female |
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Speciality | Nurse Practitioner |
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Location | 15101 Glenwood Ave, Stanley, Kansas |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1477955755
- Provider Enumeration Date: 09/18/2014
- Last Update Date: 07/25/2018
Medical Identifiers
Medical identifiers for Jessica Blake such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1477955755 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
163W00000X | Registered Nurse | 109445 (Kansas) | Secondary |
363L00000X | Nurse Practitioner | 53-76586 (Kansas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jessica Blake is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Jessica Blake, 15101 Glenwood Ave, Stanley, KS 66223-3154 Ph: () - | Jessica Blake, 15101 Glenwood Ave, Stanley, KS 66223 Ph: (913) 681-8866 |
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