Search › Illinois › 363LA2100X
Traci Blake, DNP,ACNPC-AG, CRNFA
NPI 1649543042 · on the registry since 2012
Practice
- Address
- 8201 E Riverside Blvd
Rockford, IL 61114 - Phone
- (815) 971-7000
- Organisation at this address
- Javon Bea Hospital
Javon Bea Hospital
Javon Bea HospitalInferred from a shared address, not stated in the registry. - Clinicians at this address
- 156
Additional practice sites
- 1401 E State St, Rockford, IL
- 1000 Mineral Point Ave, Janesville, WI
Registry record
- Primary taxonomy
- 363LA2100X
363LA2100X
- Also registered as
- 163WR0006X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2025-05-01
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 Illinois