Provider Demographics
NPI:1669931473
Name:BLAKE, ASHLEY RAYE (DO)
Entity type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:RAYE
Last Name:BLAKE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1210 KY HIGHWAY 36 E STE G3
Mailing Address - Street 2:
Mailing Address - City:CYNTHIANA
Mailing Address - State:KY
Mailing Address - Zip Code:41031-7492
Mailing Address - Country:US
Mailing Address - Phone:859-234-2300
Mailing Address - Fax:
Practice Address - Street 1:1210 KY HIGHWAY 36 E STE G4
Practice Address - Street 2:
Practice Address - City:CYNTHIANA
Practice Address - State:KY
Practice Address - Zip Code:41031-7491
Practice Address - Country:US
Practice Address - Phone:859-289-6311
Practice Address - Fax:859-289-3366
Is Sole Proprietor?:No
Enumeration Date:2019-03-19
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY05538207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology