Cynthia J. Blake, APRN,BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP008734 Issued in PA

Practice address

600 Macinnes Dr
Houghton, MI 49931-1144

Phone

(906) 483-1860

Fax

(906) 483-1270

NPI assigned

Jan 27, 2006

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618358400000",
    "number": "1861463994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 EXPLORER ST",
            "city": "GWINN",
            "state": "MI",
            "postal_code": "498412813",
            "telephone_number": "906-346-4924",
            "fax_number": "906-346-6474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MACINNES DR",
            "city": "HOUGHTON",
            "state": "MI",
            "postal_code": "499311144",
            "telephone_number": "906-483-1860",
            "fax_number": "906-483-1270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "CYNTHIA",
        "middle_name": "J.",
        "name_prefix": "Ms.",
        "credential": "APRN,BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-27",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP008734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Lanzara Bean, SLP
• Julie Marie Beck, LBSW
• Phyllis Bergh, RN
• Jared Berryman, DC
• Larry Binoniemi
• Body Mechanix Physical Therapy, LLC
• Whitney M Boroski, NBC-HWC
• Nathan Boyt
• Jenna Brewer
• Brian Dennis Brewster, MAT, ATC, CSCS

• Family Nurse Practitioner in Houghton, MI
• Providers in Houghton, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2021; 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.