Provider Demographics
NPI:1336374826
Name:BLAKE-MANNING, ROBYN (MSN, ARNP, PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:ROBYN
Middle Name:
Last Name:BLAKE-MANNING
Suffix:
Gender:F
Credentials:MSN, ARNP, PMHNP-BC
Other - Prefix:MRS
Other - First Name:ROBYN
Other - Middle Name:
Other - Last Name:BLAKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, ARNP, PMHNP-BC
Mailing Address - Street 1:1301 YORK RD STE 800-1106
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-6035
Mailing Address - Country:US
Mailing Address - Phone:443-850-2603
Mailing Address - Fax:443-327-4747
Practice Address - Street 1:1301 YORK RD STE 800
Practice Address - Street 2:
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-6011
Practice Address - Country:US
Practice Address - Phone:443-850-2603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-27
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR166864163W00000X, 363LP0808X, 163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163W00000XNursing Service ProvidersRegistered Nurse
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health