| Ms Kelley E Blake, CRNP | |
|
4300 W Main St Ste 45, Dothan, AL 36305-1317 | |
| (334) 944-7095 | |
| (334) 299-3870 |
| Full Name | Ms Kelley E Blake |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 4300 W Main St Ste 45, Dothan, Alabama |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770737249 | NPI | - | NPPES |
| 181693 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 1-150592 (Alabama) | Primary |
| Entity Name | Wiregrass Clinic Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558657890 PECOS PAC ID: 2860662491 Enrollment ID: O20110908002136 |
| Entity Name | B&w Medical Solutions Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1427710896 PECOS PAC ID: 5294121935 Enrollment ID: O20220406002136 |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Kelley E Blake, CRNP Po Box 6599, Dothan, AL 36302-6599 Ph: (334) 944-7095 | Ms Kelley E Blake, CRNP 4300 W Main St Ste 45, Dothan, AL 36305-1317 Ph: (334) 944-7095 |
Julia Jones Holloway, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1812 E Main St, Dothan, AL 36301 Phone: 334-792-5184 Fax: 334-792-5190 | |
Heather Young, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 480 Honeysuckle Rd, Dothan, AL 36305 Phone: 334-836-1212 | |
Jenna Oates, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 287 Healthwest Dr, Dothan, AL 36303 Phone: 334-792-9500 | |
Mrs. Samantha Poole Carter, CRNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4300 W Main St Ste 15, Dothan, AL 36305 Phone: 334-944-7056 Fax: 334-944-7063 | |
Elizabeth Ann Mcfarland, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 207 Haven Dr, Dothan, AL 36301 Phone: 334-793-3319 Fax: 334-793-2291 | |
Amanda B Imming, CRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1901 Melba Drive, Dothan, AL 36301 Phone: 334-794-6611 Fax: 334-794-6614 | |
Vickie D Sconyers, CRNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4300 West Main St, Womens Healthcare Of Dothan Pc Ste 31, Dothan, AL 36305 Phone: 334-793-6511 Fax: 334-677-5642 |