Individual provider Active NPI

Dana Chanel Blazak, MSN, FNP-C

  • Family Nurse Practitioner
  • New London, NH
National Provider Identifier
1104724111
Registry record updated Oct 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F10261079 Issued in NH
Practice address
273 County Rd
New London, NH 03257-5736
Phone
(603) 526-5000
NPI assigned
Oct 29, 2026
Last updated
Oct 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F10261079 NH Primary

Addresses

Primary practice location

273 County Rd
New London, NH 03257-5736

Mailing address

167 Pierce Lake Rd
Antrim, NH 03440-3702
Phone (918) 855-0033

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1793232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1793232000000",
    "number": "1104724111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "167 PIERCE LAKE RD",
            "city": "ANTRIM",
            "state": "NH",
            "postal_code": "034403702",
            "telephone_number": "918-855-0033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "273 COUNTY RD",
            "city": "NEW LONDON",
            "state": "NH",
            "postal_code": "032575736",
            "telephone_number": "603-526-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAZAK",
        "first_name": "DANA",
        "middle_name": "CHANEL",
        "credential": "MSN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-10-29",
        "last_updated": "2026-10-29",
        "certification_date": "2026-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NH",
            "license": "F10261079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.