Angelica Marie Blake, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

239396 Issued in AK

Practice address

41701 Tischer Ave
Soldotna, AK 99669-8504

Phone

(907) 690-3196

NPI assigned

Jun 18, 2025

Last updated

Jun 18, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Peninsula Allergy & Asthma Center LLC

  • Allergy & Immunology Physician
  • Soldotna, AK
  • NPI 1659234847
  Medicare reassignment NPD
• Alaska Heart Institute

  • Cardiovascular Disease Physician
  • Anchorage, AK
  • NPI 1992744114
  Medicare reassignment
• Curtis Buchholz PC

  dba Peninsula Pathology Institute

  • Clinical Medical Laboratory
  • Soldotna, AK
  • NPI 1770707002
  NPD (past)

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

{
    "created_epoch": "1750204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1114813706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41701 TISCHER AVE",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996698504",
            "telephone_number": "907-690-3196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41701 TISCHER AVE",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996698504",
            "telephone_number": "907-690-3196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "ANGELICA",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-18",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": "239396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Derrick Bignell
• Jeanne Bignell
• Binkley Street Dental Clinic PC
• Lydia Anna Bird, LPC, MAC
• Bitesize Pediatric Dentistry, LLC
• Michael Todd Blake, DO
• Victoria M Blakeslee
• Blossom Care Coordination LLC (Blossom Care Coordination)
• David Blossom, PHARMD
• Jennifer Blossom

• Family Nurse Practitioner in Soldotna, AK
• Providers in Soldotna, AK by specialty
• Family Nurse Practitioner in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.