Janice Blake Aprn, PLLC

Organization Active NPI Psychiatric/Mental Health Nurse Practitioner · S Glastonbury, CT

NPI 1003496829 · NPPES record last updated Jun 15, 2021

Key facts

NPI
1003496829
Entity type
Organization (NPI type 2)
Primary specialty
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
Legal business name
JANICE BLAKE APRN, PLLC
Practice address
181 Thompson St
S Glastonbury, CT 06073-2919
Phone
(860) 266-7826
NPI assigned
Apr 14, 2021
Organization subpart
No

Authorized official

Name
Janice Blake, PMHNP-BC
Title
Owner/Operator
Phone
(860) 266-7826

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner
Group: 193400000X SINGLE SPECIALTY GROUP
363LP0808X Yes

Addresses

Primary practice location

181 Thompson St
S Glastonbury, CT 06073-2919

Mailing address

181 Thompson St
S Glastonbury, CT 06073-2919

Other providers in S Glastonbury, CT

All providers in S Glastonbury, CT · Psychiatric/Mental Health Nurse Practitioner in Connecticut

Sources for this page

Verify at the official NPI Registry.