Provider Demographics
NPI:1700757986
Name:JONES, BLAKE (NP)
Entity type:Individual
Prefix:
First Name:BLAKE
Middle Name:
Last Name:JONES
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6624 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45227-4244
Mailing Address - Country:US
Mailing Address - Phone:419-560-2638
Mailing Address - Fax:513-995-2432
Practice Address - Street 1:6624 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45227-4244
Practice Address - Country:US
Practice Address - Phone:419-560-2638
Practice Address - Fax:513-995-2432
Is Sole Proprietor?:No
Enumeration Date:2025-09-12
Last Update Date:2025-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0040177363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner