LISA JOLENE BLAKE (NPI# 1376177584) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376177584 |
| Entity Type | Individual |
| Full Name | LISA JOLENE BLAKE |
| Practice Address |
1747 Heritage Ln Ste B101 Syracuse UT 84075-8546 |
| Mailing Address |
1314 24th St Ogden UT 84401-2902 |
| Practice Telephone | 3854391926 |
| Mailing Telephone | 8016955057 |
| Enumeration Date | 2020-02-26 |
| Last Update Date | 2020-02-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730699976 | Lisa D Blake | Massage Therapist | 2705 E Burnside St Ste 213, Portland, OR 97214-1768 | 2017-10-02 |
| 1588014732 | Lisa Blake | Registered Nurse | 230 Highland Ave, Somerville, MA 02143-1408 | 2016-06-20 |
| 1457767907 | Lisa Blake | Acupuncturist | 16 Bradlee Rd, Medford, MA 02155-3171 | 2014-07-05 |
| 1033384540 | Lisa Blake | Speech-Language Pathologist | 11111 Houze Rd, Suite 101, Roswell, GA 30076-5663 | 2008-04-25 |
| 1215153168 | Lisa Joy Blake | Advanced Practice Midwife | 4300 Fayetteville Rd, Lumberton, NC 28358-2677 | 2007-04-18 |
| 1861424004 | Lisa Blake | Obstetrics & Gynecology | 15 Riverbend Dr Sw, Ste 200, Rome, GA 30161-6065 | 2006-07-07 |
| Street Address |
1747 HERITAGE LN STE B101 |
| City | SYRACUSE |
| State | UT |
| Zip Code | 84075-8546 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144486895 | Marc Lee Anson | Social Worker | 1747 Heritage Ln Ste B101, Syracuse, UT 84075-8546 | 2008-08-01 |
| 1104436120 | Preston Quinn Calcut | Student in an Organized Health Care Education/Training Program | 1747 Heritage Ln Ste B101, Syracuse, UT 84075-8546 | 2020-08-04 |
| 1891313698 | Heidi Sarinda Hiatt | Social Worker | 1747 Heritage Ln Ste B101, Syracuse, UT 84075-8546 | 2020-07-08 |
| 1487294211 | April Nayomi Garcia Valdez | Social Worker | 1747 Heritage Ln Ste B101, Syracuse, UT 84075-8546 | 2020-01-09 |
| 1912540311 | Amanda Carlson | Social Worker | 1747 Heritage Ln Ste B101, Syracuse, UT 84075-8546 | 2019-10-18 |
| 1518457712 | Anson Family Counseling, LLC | Social Worker | 1747 Heritage Ln Ste B101, Syracuse, UT 84075-8546 | 2018-05-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750775235 | Syracuse Assisted Living Phase I | Assisted Living Facility | 2063 W. 1900 S., Syracuse, UT 84075 | 2015-03-24 |
| 1881975464 | Norman Kent Sharp II | Dentist | 1662 S 2000 W Ste A1, Syracuse, UT 84075 | 2011-09-08 |
| 1245471705 | Ihc Health Services Inc | Family Medicine | 745 South 2000 West, Syracuse, UT 84075 | 2009-03-13 |
| 1124240197 | Richard Jackson | Psychologist | 2650 West 2700 South, Syracuse, UT 84075 | 2007-05-02 |
| 1679799902 | Nathan Wesley Elmore | Chiropractor | 1842 South 2000 West, Syracuse, UT 84075 | 2007-04-17 |
| 1972635332 | Aspen Institute for Behavioral Assessment | Psychiatric Residential Treatment Facility | 2732 W 2700 S, Syracuse, UT 84075 | 2007-03-12 |
| 1427111558 | Sheldon L Peck | Dentist | 1747 S Heritage Lane, Suite A3, Syracuse, UT 84075 | 2006-12-19 |
| 1811081771 | Tyler R Elmore | Chiropractor | 1013 W 2700 S, Syracuse, UT 84075 | 2006-10-03 |
| 1235247438 | Brett R Coleman | Dentist | 780 S 2000 W, Bldg E304, Syracuse, UT 84075 | 2006-08-28 |
| 1164431177 | Kipton Jay Norris | Dentist | 1747 S. Heritage Ln, Suite B-201, Syracuse, UT 84075 | 2006-08-07 |
| Find all providers in zip 84075 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609475136 | Joan Sequeira | Student in an Organized Health Care Education/Training Program | 300 Audubon Pkwy Apt 95, Syracuse, NY 13224-1245 | 2020-10-26 |
| 1134728686 | Sarah Grube | Student in an Organized Health Care Education/Training Program | 5599 Thompson Rd Apt A8, Syracuse, NY 13214-1667 | 2020-10-25 |
| 1669070413 | Sarah Lynn Olszewski | Student in an Organized Health Care Education/Training Program | 451 Bryant Ave, Syracuse, NY 13204-2505 | 2020-10-14 |
| 1689281370 | Ashley Summerton | Student in an Organized Health Care Education/Training Program | 721 N Clinton St Apt 315, Syracuse, NY 13204-1255 | 2020-09-26 |
| 1811503055 | Matthew Vincent Morales I | Student in an Organized Health Care Education/Training Program | 904 Westcott St, Syracuse, NY 13210-2508 | 2020-09-22 |
| 1043826282 | Alex J Zwierzynski | Student in an Organized Health Care Education/Training Program | 172 Greenland Dr, Syracuse, NY 13208-3057 | 2020-09-22 |
| 1528674934 | Nicole Kaczor | Student in an Organized Health Care Education/Training Program | 200 Croyden Rd, Syracuse, NY 13224-1935 | 2020-09-21 |
| 1043826480 | Faustin M. Bahizi | Student in an Organized Health Care Education/Training Program | 926 Maryland Ave, Syracuse, NY 13210-2504 | 2020-09-21 |
| 1306452743 | Samantha Elizabeth Monaco | Student in an Organized Health Care Education/Training Program | 1420 Salt Springs Rd, Syracuse, NY 13214-1434 | 2020-09-21 |
| 1528686557 | Siofra Murphy | Student in an Organized Health Care Education/Training Program | 4900 Broad Rd Ste 3m, Syracuse, NY 13215-2265 | 2020-07-07 |
| Find all providers in SYRACUSE | ||||
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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.