Provider Demographics
NPI:1912188699
Name:MORRIS-BLAKE, DANA ANN (NP)
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:ANN
Last Name:MORRIS-BLAKE
Suffix:
Gender:F
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:PO BOX 202926
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-8926
Mailing Address - Country:US
Mailing Address - Phone:866-239-5133
Mailing Address - Fax:888-384-7012
Practice Address - Street 1:91 NEWARK ST
Practice Address - Street 2:UNIT D
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-1629
Practice Address - Country:US
Practice Address - Phone:720-525-7997
Practice Address - Fax:888-384-7012
Is Sole Proprietor?:No
Enumeration Date:2007-11-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONLC.0111278101Y00000X
CONP4933363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CONLC.0111278OtherCOLORADO BOARD OF PSYCHOTHERAPISTS
CO4933OtherNP FAMILY HEALTH AUTHORITY NUMBER
CORXP-1037OtherCOLORADO PRESCRIPTIVE AUTHORITY NUMBER
2019084966OtherAMER NURSES CREDENTIALING CENTER - FAMILY NURSE PRACTITIONER BOARD CERTIFICATION
CO175733OtherCOLORADO RN LICENSE NUMBER
CO56481870Medicaid
COMM2032732OtherDEA NUMBER