| Doctor Name: | CHRISTINE BLAKE |
| NPI Number: | 1184800021 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN |
| License Number: | A139948 |
| Business Practice Address: | 1401 Crees St West Liberty, IA - 527761029 |
| Business Phone Number: | 3196272131 |
| Business Fax Number: | 3196272087 |
| Mailing Address: | 540 E Jefferson St, Suite 305 IOWA CITY |
| State: | IA |
| Postal Code: | 522452477 |
| Phone Number: | 3193393672 |
| Fax Number: | 3193582737 |
| NPI Enumeration Date: | 01/10/2008 |
| NPI Last Update Date: | 03/15/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | A139948 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |