KATIE JACQUELINE BLAKE (NPI# 1053934430) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053934430 |
| Entity Type | Individual |
| Full Name | KATIE JACQUELINE BLAKE |
| Practice Address |
494 Gancedo St Sw Palm Bay FL 32908-1270 |
| Practice Telephone | 2182691483 |
| Mailing Telephone | 2182691483 |
| Enumeration Date | 2020-05-20 |
| Last Update Date | 2020-05-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3747P1801X |
Technician Specialization: Personal Care Attendant |
Nursing Service Related Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104375393 | Katie Blake | Social Worker | 470 Chadbourne Rd, Suite E, Fairfield, CA 94534-9600 | 2016-09-28 |
| 1477896462 | Katie L Blake | Nurse Anesthetist, Certified Registered | 1600 Rockland Rd, Wilmington, DE 19803-3607 | 2013-03-28 |
| Street Address |
494 GANCEDO ST SW |
| City | PALM BAY |
| State | FL |
| Zip Code | 32908-1270 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043663537 | Milena Tellechea Casanueva | Registered Nurse | 761 Santo Domingo Ave Sw, Palm Bay, FL 32908 | 2016-07-19 |
| 1023351996 | Zion's Assisted Living Facility, Inc. | Assisted Living Facility | 2029 Jupiter Blvd Sw, Palm Bay, FL 32908 | 2013-03-29 |
| 1710267364 | Laurie Kay Bailey | Massage Therapist | 3098 Cambria Avenue, Palm Bay, FL 32908 | 2011-08-26 |
| 1689797946 | Fritz Delmont | Licensed Practical Nurse | 3056 Ferdon Ave, Palm Bay, FL 32908 | 2007-04-09 |
| 1801340732 | Trinity Non Emergency Medical Transportation LLC | Non-emergency Medical Transport (VAN) | 1590 La Maderia Dr Sw, Palm Bay, FL 32908-1100 | 2016-08-09 |
| 1326354606 | Merlyn Labrador | Marriage & Family Therapist | 1500 Las Palmos Dr Sw, Palm Bay, FL 32908-1120 | 2010-08-25 |
| 1245544303 | Matthew M Fisher | Massage Therapist | 1570 Las Palmos Dr Sw, Palm Bay, FL 32908-1120 | 2010-07-31 |
| 1780999284 | Colleen M Fisher | Massage Therapist | 1570 Las Palmos Dr Sw, Palm Bay, FL 32908-1120 | 2010-08-10 |
| 1922271220 | Marrilyn K Tennyson | Occupational Therapist | 1700 Las Palmos Dr Sw, Palm Bay, FL 32908-1122 | 2008-04-08 |
| 1528531076 | Al-quiyamah Ghafur Faiz | Counselor | 1606 Sawgrass Dr Sw, Palm Bay, FL 32908-1126 | 2019-01-08 |
| Find all providers in zip 32908 | ||||
| Taxonomy Code | 3747P1801X |
| Grouping | Nursing Service Related Providers |
| Classification | Technician |
| Specialization | Personal Care Attendant |
| An individual who provides assistance with eating, bathing, dressing, personal hygiene, activities of daily living as specified in the plan of care. Services which are incidental to the care furnished, or essential to the health and welfare of the individual may also be provided. Personal care providers must meet state defined training and certification standards |
| Notes: [7/1/2003: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689290264 | Amanda Michelle White | Technician | 938 Geary St Sw, Palm Bay, FL 32908-4206 | 2020-06-19 |
| 1841832789 | Amanda N Body | Technician | 411 Mercer St Nw, Palm Bay, FL 32907-2934 | 2019-10-11 |
| 1588129753 | Pauline Romans | Technician | 2480 Emerson Dr Se, Palm Bay, FL 32909-4972 | 2019-02-01 |
| 1528531845 | Shannon Phillips | Technician | 215 Fitchburg St Sw, Palm Bay, FL 32908-1302 | 2019-01-09 |
| 1831661669 | Junie Benoit | Technician | 205 Breckenridge Cir Se, Palm Bay, FL 32909-2337 | 2018-12-18 |
| 1295206498 | Karla Patricia Sabillon | Technician | 1272 Thallar Ln Nw, Palm Bay, FL 32907-1018 | 2018-12-16 |
| 1184195315 | Vivian S Rodriguez | Technician | 1799 Macklin St Nw, Palm Bay, FL 32907-8073 | 2018-12-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285232967 | Amanda Darnell O'berry | Technician | 6531 Berryhill Rd, Milton, FL 32570-6822 | 2020-10-14 |
| 1598363590 | Bergeline Lexis | Technician | 8836 Viking Ln, Lakeland, FL 33809-1751 | 2020-10-12 |
| 1629685201 | Lynda Wilkes Dekold | Technician | 4110 Sw 63rd Blvd, Gainesville, FL 32608-3924 | 2020-09-28 |
| 1134736952 | Robin Lynn Knight | Technician | 1125 Anolas Way, Lutz, FL 33548-2902 | 2020-09-25 |
| 1689289969 | Golden Life Senior Services LLC | Technician | 2595 Sanford Ave, Sanford, FL 32773-4606 | 2020-09-13 |
| 1760096945 | Hermina Cyntje | Technician | 13060 Waterbourne Dr, Gibsonton, FL 33534-3908 | 2020-09-03 |
| 1154933273 | Erica Petithomme | Technician | 3935 Ne 22nd Ave, Cape Coral, FL 33909-3282 | 2020-08-19 |
| 1063021889 | Stacey Wilcox | Technician | 1447 Nw Wayne Pl Apt 105, Lake City, FL 32055-6107 | 2020-07-28 |
| 1073130498 | Maureen Ann Stewart | Technician | 189 Citrus Trail Circle, Boynton Beach, FL 33436 | 2020-07-01 |
| 1750905196 | Lakysha N Harper | Technician | 1478 Bentley Cir, Fort Walton Beach, FL 32547-1975 | 2020-06-02 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.