IndividualActive
Judith Blake, PA-C
NPI 1942749965 · Surgical Physician Assistant · Daphne, AL
Provider details
- NPI number
- 1942749965
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- License
- PA.1207 (AL)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
1505 Daphne Ave
Daphne, AL 36526-4298
Phone: (251) 625-2663
Fax: (251) 625-3198
Approximate (ZIP-level) locationGet directions
Mailing address
1505 Daphne Ave
Daphne, AL 36526-4298
Registry dates
- Enumerated
- 2017-02-23
- Last updated
- 2023-10-16
- Certified
- 2023-10-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.