Provider Demographics
NPI:1659680601
Name:CURRENS, BLAKE A (PA-C)
Entity Type:Individual
Prefix:
First Name:BLAKE
Middle Name:A
Last Name:CURRENS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5001 TRANSPORTATION DR
Mailing Address - Street 2:
Mailing Address - City:SHEFFIELD VILLAGE
Mailing Address - State:OH
Mailing Address - Zip Code:44054-2849
Mailing Address - Country:US
Mailing Address - Phone:440-329-2800
Mailing Address - Fax:440-329-2810
Practice Address - Street 1:5001 TRANSPORTATION DR
Practice Address - Street 2:
Practice Address - City:SHEFFIELD VILLAGE
Practice Address - State:OH
Practice Address - Zip Code:44054-2849
Practice Address - Country:US
Practice Address - Phone:440-329-2800
Practice Address - Fax:440-329-2810
Is Sole Proprietor?:No
Enumeration Date:2010-09-24
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50-003109363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0070450Medicaid
OHCUPA84261Medicare PIN