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Charles Blake, RN — NPI 1043224272, Nixa, MO | NPI Central

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NPI 1043224272

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Charles Blake, RN

NPI 1043224272 · Registered Nurse · Nixa, MO

Provider details

NPI number: 1043224272
Entity type: Individual
Primary specialty: Registered NurseNursing Service Providers
Credential: RN
Sex: Male
Sole proprietor: Yes
License: 088073 (MO)

Specialties & taxonomies

Registered NursePrimary163W00000XLicense 088073 (MO)
Nursing Service Providers

Practice location

208 N 36th St

Nixa, MO 65714-7560

Phone: (417) 343-4202

Fax: (417) 869-1521

Approximate (ZIP-level) locationGet directions

More MO providers

Mailing address

208 N 36th St

Nixa, MO 65714-7560

Registry dates

Enumerated: 2006-07-27
Last updated: 2007-07-08

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.