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Blake Wollam
Family Nurse Practitioner in Mentor, Ohio
NPI 1013643048

Blake Wollam is a Family Nurse Practitioner based in Lakewood, OH and is specialized in Family. Blake Wollam practices in Mentor, OH. The NPI Number for Blake Wollam is 1013643048 and holds a License No. APRN.CNP.0031396 (Ohio).

The current practice location address for Blake Wollam is 7060 Wayside Dr, Mentor, OH and can be reached out via phone at 440-357-2770.

Location: 7060 Wayside Dr, Mentor, OH, 44107-5715
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1013643048
Provider Name
Blake Wollam
Credential
Provider Entity Type
Individual
Gender
Male
Address
7060 Wayside Dr, Mentor, OH, 44107-5715
Phone Number
440-357-2770
Fax Number
Provider Enumeration Date
08/01/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
7060 Wayside Dr
City
Mentor
State
Ohio
Zip
44060-6527
Phone Number
440-357-2770
Fax Number
person
Provider Business Mailing Address Details
Address
7060 Wayside Dr
City
Mentor
State
Ohio
Zip
44060-6527
Phone Number
440-357-2770
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
APRN.CNP.0031396 (Ohio)
Definition
Definition to come...
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