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Donna Marie Blake
Student in an Organized Health Care Education/Training Program in Bridgeport, Connecticut
NPI 1033789508

Donna Marie Blake is a Student in an Organized Health Care Education/Training Program based in Bridgeport, CT. Donna Marie Blake practices in Bridgeport, CT. The NPI Number for Donna Marie Blake is 1033789508 and holds a License No. 68942 (Connecticut).

The current practice location address for Donna Marie Blake is 1635 Central Ave, Bridgeport, CT and can be reached out via phone at 203-551-7091.

Location: 1635 Central Ave, Bridgeport, CT, 06610-2717
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1033789508
Provider Name
Donna Marie Blake
Credential
Provider Entity Type
Individual
Gender
Female
Address
1635 Central Ave, Bridgeport, CT, 06610-2717
Phone Number
203-551-7091
Fax Number
Provider Enumeration Date
06/28/2021
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
68942 01 CT DPH
institution
Provider Business Practice Location Address Details
Address
1635 Central Ave
City
Bridgeport
State
Connecticut
Zip
06610-2717
Phone Number
203-551-7091
Fax Number
person
Provider Business Mailing Address Details
Address
1635 Central Ave
City
Bridgeport
State
Connecticut
Zip
06610-2717
Phone Number
203-551-7091
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
68942 (Connecticut)
Definition
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.
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