Provider Demographics
NPI:1447956305
Name:STONE, BLAKE OKEEFE (FNP-BC)
Entity type:Individual
Prefix:
First Name:BLAKE
Middle Name:OKEEFE
Last Name:STONE
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9505 SILVER COLLECTION CIR APT 410
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22408-7893
Mailing Address - Country:US
Mailing Address - Phone:540-907-0064
Mailing Address - Fax:
Practice Address - Street 1:4600 SPOTSYLVANIA PKWY
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22408-7762
Practice Address - Country:US
Practice Address - Phone:540-498-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-02
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024186356363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily