Opal Blake, NP-C

NPI 1043629140 · on the registry since 2014

Practice

Address: 631 Professional Dr Ste 350
Lawrenceville, GA 30046
Phone: (770) 995-0630
Fax: (770) 995-1555
Organisation at this address: Walgreen Co
Cavells Inc
Georgia Urology, Pa
Charles B Moomey Jr Md
Wallace F. Martin, M.D.
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 101

Registry record

Primary taxonomy: Nurse Practitioner
363L00000X
Also registered as: Nurse Practitioner
Licence states on file: GA
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2016-01-04

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia