Provider Demographics
NPI:1437025988
Name:BLAKE, DAUNNE PATRISHA
Entity type:Individual
Prefix:
First Name:DAUNNE
Middle Name:PATRISHA
Last Name:BLAKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:247 CONNECTICUT AVE UNIT 2
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06854-1906
Mailing Address - Country:US
Mailing Address - Phone:203-590-0625
Mailing Address - Fax:
Practice Address - Street 1:247 CONNECTICUT AVE UNIT 2
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06854-1906
Practice Address - Country:US
Practice Address - Phone:203-590-0625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-13
Last Update Date:2025-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT46411164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Multi-Specialty